Postulate 1 of the Republican theory of government :The rich have too little and the poor too much.
348
The problem for the Republicans is they can't sell the truth. The truth is they don't want government to be in healthcare. Full stop. They don't believe healthcare is a fundamental human right, but rather one you deserve by being rich enough. Remember when Trump said of course they didn't want people dying in the streets? That's only because then they'd have to spend money picking up their remains. They'll mouth all sorts of nonsense about not wanting it because government shouldn't be involved in healthcare (unless it's women's reproductive care, of course) because they're inept at it. And then they put together a plan to ensure that's true. So you see - this is not a bug, but the plan. Government will run healthcare ineffectively and people will not be on government provided healthcare - two goals met.
257
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You are right on a key point-- Obama compromised and capitulated before the Republicans even got the table!
He turned health care over to Max Baucus, the single biggest mistake of the entire enterprise. Obama also washed his hands of it all.
He rightly campaigned vigorously and bluntly against the individual mandate -- the cornerstone of Hillary's plan -- and he called for the public option. He abandoned both positions within minutes of turning over health care reform to Baucus.
He also had called for the health care debate to be held in public, broadcast on C-Span, believing correctly that the light of day would reveal the vacuous nature of the Republican and Clinton stances. He abandoned that, too!
The single biggest failing, however, was Obama's silence -- his failure to capitalize on his brilliant speaking skills and his ability to engage the public. He could have gotten an expansion of Medicare to age 55 and even passed a public option for everyone by going to the country and rallying the people.
It is so sad to see a major columnist heartlessly deride such options and the much-needed single payer health care reform as "Kumbaya" plans.
Even in its design, Obamacare left tens of millions uncovered-- and tens of millions poorly covered at excessively high cost. The Republicans' pretend "repeal and replace" plan does far, far worse.
------------------------------------
You are right on a key point-- Obama compromised and capitulated before the Republicans even got the table!
He turned health care over to Max Baucus, the single biggest mistake of the entire enterprise. Obama also washed his hands of it all.
He rightly campaigned vigorously and bluntly against the individual mandate -- the cornerstone of Hillary's plan -- and he called for the public option. He abandoned both positions within minutes of turning over health care reform to Baucus.
He also had called for the health care debate to be held in public, broadcast on C-Span, believing correctly that the light of day would reveal the vacuous nature of the Republican and Clinton stances. He abandoned that, too!
The single biggest failing, however, was Obama's silence -- his failure to capitalize on his brilliant speaking skills and his ability to engage the public. He could have gotten an expansion of Medicare to age 55 and even passed a public option for everyone by going to the country and rallying the people.
It is so sad to see a major columnist heartlessly deride such options and the much-needed single payer health care reform as "Kumbaya" plans.
Even in its design, Obamacare left tens of millions uncovered-- and tens of millions poorly covered at excessively high cost. The Republicans' pretend "repeal and replace" plan does far, far worse.
------------------------------------
162
Trump's White House also estimated the impact of Trumpcare and predicted 26 million would lose health coverage by 2026, closely matched to the "virtually impossible" CBO estimate of 24 million. Sad!
http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-23...
http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-23...
64
When will the out-of-date GOPs realize that the world has left it behind and the richest country in the world wants to continue to expand real health care coverage with our tax dollars, not a tax rebate for the 2% who don't even pay their fair share? They are such a sad and pathetic throwback joke of a corrupt Party, with their absurd and lying "leaders" spouting nonsense all the live-long day on fake-news Fox, which no one in her right mind watches. With this craven Ryan/Trump bill, the willfully ignorant Trump voters and everyone else dies when science and common sense could save them. And rurals won't even be able to get their opioids if they can't afford health care; they'll have to go straight to the drug traffickers who live in Trump Tower. Or perhaps the trashy Trump family will brand their own opioids in China? And the filthy pipeline/fossil-fuel-lovin' crowd will lace the waters with more poison and kill off the rest. American carnage indeed! Sounds like the GOPS are just going to continue all their big and little health-care lies to keep their fat butts well stabled in ridiculous Mar-a-Lagos at taxpayers' expense and just walk all over the corpses on their immigrant-tended front lawns and polluting golf courses.
157
Trump promised coverage for everyone at lower costs (to individuals), and that there would be no cuts to medicaid. Now his plan breaks all of his promises. This is not "great healthcare, much better and cheaper than Obamacare". In an ironic twist, many of the people who will suffer loss of coverage and/or far higher costs when Trumpcare passes, are Trump's supporters.
We know this. Trump knows this. Ryan and McConnell know this. Do Trump's voters know this? What happens when they find out?
We know this. Trump knows this. Ryan and McConnell know this. Do Trump's voters know this? What happens when they find out?
158
From the article:
Frank Luntz wrote an influential memo in 2009 advising Republicans to talk positively about “reform” while also opposing actual solutions. McConnell, the Senate leader, persuaded his colleagues that they could make Obama look bad by denying him bipartisan cover.
What the Republicans are always doing.
Frank Luntz wrote an influential memo in 2009 advising Republicans to talk positively about “reform” while also opposing actual solutions. McConnell, the Senate leader, persuaded his colleagues that they could make Obama look bad by denying him bipartisan cover.
What the Republicans are always doing.
121
If we ever wondered how low the Republicans will go to serve their masters, the 400 who will receive the tax cuts, we now know. This is the first volley. The next will be cuts to Medicare and Social Security.
Gee, folks, you may have to start passing mom around between the siblings until she dies. Wait, you are an only child? Tough. If you didn't want to support your parents in their old age, you shouldn't have had them. Just ask Paul Ryan who grew up on Social Security survivor benefits after his father died, the moocher.
Gee, folks, you may have to start passing mom around between the siblings until she dies. Wait, you are an only child? Tough. If you didn't want to support your parents in their old age, you shouldn't have had them. Just ask Paul Ryan who grew up on Social Security survivor benefits after his father died, the moocher.
206
Bang your head against a wall, the clear fact is, the ignorant will never learn. The savings and loan scandal, the balloon mortgage scandal (reversed or otherwise), the destruction of the Affordable Care Act, all under republican leadership. It's as H.L. Mencken predicted. One day plain folk will have gotten their way and elect a complete moron to the White House.
194
This is an excellent piece and continues to shed light on the train wreck we call the Trump administration. At the same time, let's keep in mind that it is Lyin' Ryan, Witch McConnell, and Prince Rebus who are pushing this garbage on the citizens of this country. And the party follows, except for the Freedom Caucus who have their health care and are saying to hell with the rest of the country. Maybe the senators and congressmen should pay like the rest of us.
98
The GOP propaganda machine is already at defcon 5 following the CBO report. You will hear, over and over, repeated ad nauseum, that Trumpcare guarantees "access" to health care to all Americans. Access, access, access.
Of course access isn't the same as coverage. Under this proposal, access means that if you are seriously ill, and poor or elderly, you can shop for health insurance until you drop . . .dead, because you won't be able to pay the exorbitant premiums or ludicrous monthly deductibles.
Access, the Republicans' new favorite word, is a cruel joke played upon those whose need for medical care is both desperate and unattainable.
Of course access isn't the same as coverage. Under this proposal, access means that if you are seriously ill, and poor or elderly, you can shop for health insurance until you drop . . .dead, because you won't be able to pay the exorbitant premiums or ludicrous monthly deductibles.
Access, the Republicans' new favorite word, is a cruel joke played upon those whose need for medical care is both desperate and unattainable.
124
I remember the republican's stall tactics and obstructionism during the early efforts to create the ACA. They never had any intention of cooperating, only delaying and undermining. The people who speak for the GOP today are the best liars in the world. They have the eager support of a Right-wing echo chamber that is Rupert Murdoch's disinformation empire to repeat their lies endlessly until even the most preposterous lie becomes plausible among the gullible. Now the GOP has its Liar-in-Chief in the White House who has already taken dishonesty to levels never seen before in american politics. If the badly dazed and confused republican base doesn't wake up soon, the GOP will get away with the horrific damage they've done (and will do) to this country.
98
Let me get this straight. Democratic majorities with a Democratic President not to mention Nixon couldn't pass national health care so the Democrats moved to the right and passed a bipartisan bill all by themselves. Lost the House, Senate and now the Presidency mostly on attacks of the ACA and it's the fault of the Republicans.
We know the Republicans have moved to the right. We know they don't support universal coverage or access for the poor and elderly. That's not an excuse for the ACA being a bi-partisan plan that is largely hated.
Politically Republicans are killing the Democrats. They are about to take over the entire US judiciary and take away the ACA. They can't take away Medicare and SS because they are great plans that the public supports. The ACA isn't and the democrats have only themselves to blame.
We know the Republicans have moved to the right. We know they don't support universal coverage or access for the poor and elderly. That's not an excuse for the ACA being a bi-partisan plan that is largely hated.
Politically Republicans are killing the Democrats. They are about to take over the entire US judiciary and take away the ACA. They can't take away Medicare and SS because they are great plans that the public supports. The ACA isn't and the democrats have only themselves to blame.
27
Thank you, Mr. Lionhardt, for calling the Republican lie what it is.
And now they are attempting to compound the lie on the backs of the people who put Trump in power, using every racist white nationalist trick in the Republican playbook.
68
Let's not forget the role of the Koch Brothers and their associates in ginning up opposition to the ACA and threatening Republicans if they supported it. Kochs and others provided monetary support and more to the Tea Party as well. See Jane Mayer's Dirty Money.
It might have been more useful if the Times had kept "The Lie" in front of readers in every discussion of health reform since 2009. Eight years later, the lie is too entrenched for David Leonhardt or anyone else to dislodge it.
48
About the CBO - what is that anyway? And what is nonpartisan mean? These days there is nothing 'nonpartisan'. The CBO is a left leaning organization staffed by democrat sympathizers which puts out 'unbiased' analyses to supposedly illuminate what is really in some piece of legislation. The Obama holdovers are bad mouthing Trumpcare. Just because I have full coverage, affordable insurance doesn't mean I have to stand by and pay high taxes for subsidies.
The CBO people report to somebody, and now those somebodys are republicans.
If republicans can fire acting AG's and US attorneys, then they can fire the CBO.
The CBO people report to somebody, and now those somebodys are republicans.
If republicans can fire acting AG's and US attorneys, then they can fire the CBO.
6
Had the term "Obamacare" been left out of our lexicon, there would be far more support for ACA. I care, you care, we all care. But naming important legislation after someone who cares about coverage, but doesn't care about bilateral support is doomed to the notoriety his name provokes.
Call it WeCare, or AllCare, put drop the appelation. It's like giving a Nobel Peace Prize to so someone who never found a way to bring more peace to the people he served.
Call it WeCare, or AllCare, put drop the appelation. It's like giving a Nobel Peace Prize to so someone who never found a way to bring more peace to the people he served.
13
Many trump supporters will choose to believe the lies until their new trumpcare insurance bill comes due. It will adversely effect a lot of those "old white guys" that voted for him.
67
Republicans made a shambles out of their own plan from decades ago. The ACA is not Obamacare. Obamacare is the original Republican plan and that is why is it so riddled with inefficiencies. Now even more conservative Republicans from Reagan's day want to take apart a plan they devised decades ago and replace it with even a worse plan. Yes indeed the Republicans are a party of nincompoops and loyal to theories which might make Ayn Rand shrug but would deeply harm American Society. Republicans led by the brains of their operation, Paul Ryan, are dangerously wrong. They are a delusional lot of ignoramuses and harmful to US. What in God's name are they doing leading this nation?
DD
Manhattan
DD
Manhattan
55
The GOP's attitude: if you can't afford health insurance, you don't deserve it.
Even if you work full time, 40 hours a week, you do not deserve it.
Even though you live in one of the most prosperous countries on the planet, you don't deserve it.
Even though you take care of my elderly parents, you don't deserve it.
Even though you support my child with disabilities, you don't deserve it.
Even though you take care of my baby, you don't deserve it.
The lack of morals and empathy of McConnell and Ryan and their ilk is stunning.
Even if you work full time, 40 hours a week, you do not deserve it.
Even though you live in one of the most prosperous countries on the planet, you don't deserve it.
Even though you take care of my elderly parents, you don't deserve it.
Even though you support my child with disabilities, you don't deserve it.
Even though you take care of my baby, you don't deserve it.
The lack of morals and empathy of McConnell and Ryan and their ilk is stunning.
136
The bill coming out of Congress is flawed, and in its own way, no better than the plan Barack Obama sponsored. The Republicans had 8 years to come up with a bill and this was the best they could do? They should scrap this plan immediately and keep the status quo until such time as they can agree on a bipartisan bill (ha! ha!). However, the result of this decision will bring about the "Death Spiral" that all Republicans talk about. I believe it to be so. But maybe that is the only way we get a bill that works.
When the ACA dies its inevitable death, both sides of Congress will be forced to work together and come up with a plan that is better and more effective than anything that has been proposed or implemented.
The idea that the Government can create another entitlement like the ACA and then have Republicans take it away is absurd. Once you give an entitlement to the People you can never take it away. Don't they understand that? As bad as Obamacare is some people rely on it.
When the ACA dies its inevitable death, both sides of Congress will be forced to work together and come up with a plan that is better and more effective than anything that has been proposed or implemented.
The idea that the Government can create another entitlement like the ACA and then have Republicans take it away is absurd. Once you give an entitlement to the People you can never take it away. Don't they understand that? As bad as Obamacare is some people rely on it.
13
Hey, Trump is not a details guy. This stuff is all about the details. When he hits the road to drum up public support, he will be (i) reading details someone else wrote that he doesn't understand, and/or (ii) just harumping about Obamacare being a failure.
Kellyanne will clear everything up.
Kellyanne will clear everything up.
56
From Wikipedia:
1. Up to at least 2009, Americans overwhelmingly supported a single payer system such as Medicare for All.
"Between 2003 to 2009, 17 opinion polls showed public support for a single-payer system.[25] These polls are from sources such as CNN,[26] AP-Yahoo,[27][28] Quinnipiac,[29] New York Times/CBS News Poll,[30][31] Washington Post/ABC News Poll, [32] Kaiser Family Foundation[33] and the Civil Society Institute. [34]
In October 2003, a Washington Post poll found that 62% supported "a universal health insurance program, in which everyone is covered under a program like Medicare that's run by the government and financed by taxpayers."[35]"
2. All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
3. Obama made the decision to take single payer off the table from the get go. Whether this decision was made to appease the insurance industry, to make large contributors happy, because he saw it as a political win, or it is the best he thought he could do, is irrelevant.
It was the wrong decision.
It has left us with a complicated system that is too easy to attack
1. Up to at least 2009, Americans overwhelmingly supported a single payer system such as Medicare for All.
"Between 2003 to 2009, 17 opinion polls showed public support for a single-payer system.[25] These polls are from sources such as CNN,[26] AP-Yahoo,[27][28] Quinnipiac,[29] New York Times/CBS News Poll,[30][31] Washington Post/ABC News Poll, [32] Kaiser Family Foundation[33] and the Civil Society Institute. [34]
In October 2003, a Washington Post poll found that 62% supported "a universal health insurance program, in which everyone is covered under a program like Medicare that's run by the government and financed by taxpayers."[35]"
2. All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
3. Obama made the decision to take single payer off the table from the get go. Whether this decision was made to appease the insurance industry, to make large contributors happy, because he saw it as a political win, or it is the best he thought he could do, is irrelevant.
It was the wrong decision.
It has left us with a complicated system that is too easy to attack
19
Obama destroyed his own health insurance policy with his mass immigration policy. Nobody wants to fork over big taxes to insure people who were screaming Death To the Great Satan a few months ago.
Sociological fact: you can have diversity or you can have solidarity. You can't have both.
Sociological fact: you can have diversity or you can have solidarity. You can't have both.
7
I don't think Congressional Republicans covered themselves with glory in their handling of health care either then or now. And the Republican health plan seems to be too bold and too timorous at the same time. The GOP won the election. It is time for the Republicans to grow up and govern. The leadership needs to knock their heads together.
But none of that justifies Leonhardt's outrageous spin. Why doesn't he leave the dirty work to Paul Krugman?
Ignore the headline, and read Leonhardt's column more carefully. You will see that ACA was passed -- jammed through -- without a single Republican vote. (At a time, btw, when the economy was calling out for leadership from Washington).
Another point is that it was a bad plan, full of optical illusions and fiscal gamesmanship. It did nothing for cost control. Folks, the proof is in the pudding -- it was going to fail even without the assistance of the GOP.
It is also disingenuous to quote the reptile Frank Luntz and imply that the GOP marched to his drum. Do I have to tell you that correlation isn't causation? Everyone knows why the Republicans opposed ACA. Apart from the fact that it was a bad plan, even if some Republicans had worked on early drafts of the bill, the GOP was paralyzed by the Tea Party insurgency. I said they didn't cover themselves in glory. But ducking hard choices -- lying in the weeds and sniping at the majority -- at is one of the luxuries of being in opposition, as today's Democrats illustrate.
But none of that justifies Leonhardt's outrageous spin. Why doesn't he leave the dirty work to Paul Krugman?
Ignore the headline, and read Leonhardt's column more carefully. You will see that ACA was passed -- jammed through -- without a single Republican vote. (At a time, btw, when the economy was calling out for leadership from Washington).
Another point is that it was a bad plan, full of optical illusions and fiscal gamesmanship. It did nothing for cost control. Folks, the proof is in the pudding -- it was going to fail even without the assistance of the GOP.
It is also disingenuous to quote the reptile Frank Luntz and imply that the GOP marched to his drum. Do I have to tell you that correlation isn't causation? Everyone knows why the Republicans opposed ACA. Apart from the fact that it was a bad plan, even if some Republicans had worked on early drafts of the bill, the GOP was paralyzed by the Tea Party insurgency. I said they didn't cover themselves in glory. But ducking hard choices -- lying in the weeds and sniping at the majority -- at is one of the luxuries of being in opposition, as today's Democrats illustrate.
6
Republicans--the new death panels.
28
It's just so bizzarre. It just seems the GOP just can't be the party of pragmatic solutions. Every domestic policy has to get distorted through this purist ideological lens. This has been going on for years, and their base would eat it up: "Don't take away my liberty!"
Now with healthcare they're finding that their ideological lens is now being targeted against the people who have been putting them in office. Before, they would try to take benefits away from "welfare queens in cadillacs". But now, they're trying to take benefits away from their base! Good luck with that guys.
Now with healthcare they're finding that their ideological lens is now being targeted against the people who have been putting them in office. Before, they would try to take benefits away from "welfare queens in cadillacs". But now, they're trying to take benefits away from their base! Good luck with that guys.
23
There is another big lie about the ACA. A dozen or so Republican governors decided not to expand Medicaid coverage in their states to further undermine the ACA, so they could say that Obamacare wasn't working. The cynical and mean spirited Republican party is the party of the oligarchs, with the megaphone provided by Fox.
38
I watched the Finance Committee hearings on the ACA. Chairman Baucus worked his tushy off trying to bring Republican members into the mix. To no avail. Even Olympia Snow was a no-go.
Trumpcare ("fraudster's care") is an abomination. Lying about the facts is not pretty; that republicans intend to disenfranchise the poor from the very thing (health care) the G.O.P. elite enjoys, and sell fiction, seems contagious, "a la Trump", a total disregard for the truth, and the awful consequences (no preventive measures, no timely care for disease, early death) for the least among us. Are we so selfish that we refuse to see beyond our nose? Does the famous CW "how do we know politicians are lying? When they open their mouth" double talk ring true? Hypocrisy and shamelessness, oblivious to consequences? If you listen to Trump, Ryan, McConnell, Price, and their ilk, lying with a straight face, the assumption must be they had a lot of practice; and you would be right most of the time. If there is justice in this world, these rascals must be confronted and their dirty tricks uncovered...and stopped, before it's too late to remedy.
Paul Ryan calls it "the nightmare of Obamacare." The White House has sent out an email saying "Obamacare has been a complete failure since the beginning and things are getting worse." Then they ask you to share your "disaster story" of Obamacare. Things are getting worse, alright, but it has nothing to do with the ACA. Just with a soulless Republican party that traded its moral compass for money and power. They have no shame.
Obamacare has not worked they way it was designed for one primary reason - the Republicans (federal and state level) would not let it work...would not even give it a chance of working...Why ? Simple -because they refused to let an Obama presidency succeed; and because they have never really cared about the poor, aged, or disabled or about the working class, if it meant the elites would not benefit financially.
The fact that - after 7 years of disparaging everything about Obamacare - this is what they came up with as a solution, tells us that they never cared about a "solution" to health care for the American people - they only cared about
running it into a ditch so they could say it failed on its own and we should be grateful to them for coming up with another option - I hope the American people are too smart to fall for this obvious sham.
The fact that - after 7 years of disparaging everything about Obamacare - this is what they came up with as a solution, tells us that they never cared about a "solution" to health care for the American people - they only cared about
running it into a ditch so they could say it failed on its own and we should be grateful to them for coming up with another option - I hope the American people are too smart to fall for this obvious sham.
40
"How did the party leaders put themselves in this position?"
The sad, honest truth is that it is more important to them that they not let Obama have that win. They can't let him have that legacy. Why? We could be generous and say it was to make the Democrats look bad, but we all know it was to make the black man look bad. They will do anything to erase any sign that he was ever president.
The sad, honest truth is that it is more important to them that they not let Obama have that win. They can't let him have that legacy. Why? We could be generous and say it was to make the Democrats look bad, but we all know it was to make the black man look bad. They will do anything to erase any sign that he was ever president.
This excellent article should be required reading for all Americans who can comprehend more than 140 characters at a time. Unfortunately, the people who most need to learn the truth are listening to alternative facts on faux news.
Trump promised: "We're going to have insurance for everybody. There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."
We all know there's only one way to keep that promise: Admit that when it comes to healthcare, people are more important than profits to CEOs and shareholders. His supporters should be demanding Medicare for all.
https://www.washingtonpost.com/politics/trump-vows-insurance-for-everybo...
Trump promised: "We're going to have insurance for everybody. There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."
We all know there's only one way to keep that promise: Admit that when it comes to healthcare, people are more important than profits to CEOs and shareholders. His supporters should be demanding Medicare for all.
https://www.washingtonpost.com/politics/trump-vows-insurance-for-everybo...
40
Watching Paul Ryan looking gleeful at the thought of so many more uninsured Americans is nauseating. The Republican lie about PBO's shutting them out of the drafting of the ACA is probably the biggest of all the lies they spew daily to hold on to power-and they have many media outlets-right wing radio and Fox News-who are complicit in their never-ending propaganda. I am sure they think they can continue to fool many of their voters about what this horrid bill will do-and they probably will. At bottom, a lot of the GOP base would rather be scammed by white politicians than ever admit that a black President cared about their well-being. Oh well, at least I know I'll sleep better at night knowing that Charles and David Koch will have a little more money in their wallets every week because of the tax they won't have to pay to help some of their fellow Americans get health insurance.
30
The ACA was never a "compromise." Including a public option was to have been a compromise. The ACA was a capitulation to the insurance & drug lobby, and it was essentially the Republican plan, until the Democrats passed it. But the lobbyists wanted to have a debate from the right, not a debate from the left, and the Republicans provided. Eight long years later, they remember none of this.
30
I have yet to understand just how the ACA has failed. The evidence all seems to point to its success, while Republicans uniformly howl about the "disaster" of health care in the US. What disaster? If I did not have coverage from my employment, I would be able to afford coverage under the ACA, but not under the new proposed plan. Math speaks.
43
Two facts, both of which underscore and support Mr. Leonhardt's conclusions:
(1) He writes "Democratic attempts to cover the uninsured stretch back almost a century."
In fact, such efforts began with the Republican/"Bull Moose" party Teddy Roosevelt and go back to at least 1915:
http://teddyrooseveltlive.com/2014/09/10/teddy-roosevelt-and-healthcare/
http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-...
(2) The ACA bill called "Obamacare" was in fact not drafted by Obama, but by the "gang of six" senators: three Democrats and three Republicans
http://en.wikipedia.org/wiki/Gang_of_Six#Health_care.2C_2009
I guess "GangOfSixCare" just doesn't have the right ring to it.
(1) He writes "Democratic attempts to cover the uninsured stretch back almost a century."
In fact, such efforts began with the Republican/"Bull Moose" party Teddy Roosevelt and go back to at least 1915:
http://teddyrooseveltlive.com/2014/09/10/teddy-roosevelt-and-healthcare/
http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-...
(2) The ACA bill called "Obamacare" was in fact not drafted by Obama, but by the "gang of six" senators: three Democrats and three Republicans
http://en.wikipedia.org/wiki/Gang_of_Six#Health_care.2C_2009
I guess "GangOfSixCare" just doesn't have the right ring to it.
21
If Republicans believe that our Military should protect all of our citizens rich or poor, no matter the taxes they pay, then why don't they believe the good health of our citizens is just as important to our nation and should be equally protected? It's beyond me what the Republicans want other than to stay in power. The harder they try to hold on to that prize, the harder it will be to keep it. Some times you have to be willing to let something go to have it come back to you.
23
Re: "The Original Lie ...." Thank you Mr. Leonhard; it is good to see you on the Op Ed pages. Placed in a 100 year historical context and well annotated with potent links, your analysis cuts to bottom line, Trumpcare drains $337 Billion out of the health care system, starves the States of Medicaid subsidies, and sends the uninsured back to the ER. If Trumpacare passes, please take an early and hard look at the impact on mortality rates. Our national health care issues, both insured and uninsured remain unresolved.
28
Thanks: it's been so frustrating hearing this claim time again. Five minutes in the net archives proves the lie.
WaPo did a piece on the origin of the "death spiral" claim, now being spouted by trump and republicans ad nauseum: no surprise it comes from the CEO of Aetna angry over the Obama Administration refusing the merger with Humana. And what better way to ensure the ACA exchanges fail but by a concerted effort of insurance companies pulling out, and Rubio accommodating them with reduced funding for losses. Add to that the prohibition on advertising to encourage sign ups for 2017, and the IRS being directed and the word put out that the mandate won't be enforced.
Bernie's townhall in McDowell, WV this evening was encouraging: people are waking up to the republican games & plans; minds are being changed in the long battle for healthcare to become a right of all citizens.
https://www.washingtonpost.com/news/wonk/wp/2017/02/15/aetna-ceo-says-ob...
WaPo did a piece on the origin of the "death spiral" claim, now being spouted by trump and republicans ad nauseum: no surprise it comes from the CEO of Aetna angry over the Obama Administration refusing the merger with Humana. And what better way to ensure the ACA exchanges fail but by a concerted effort of insurance companies pulling out, and Rubio accommodating them with reduced funding for losses. Add to that the prohibition on advertising to encourage sign ups for 2017, and the IRS being directed and the word put out that the mandate won't be enforced.
Bernie's townhall in McDowell, WV this evening was encouraging: people are waking up to the republican games & plans; minds are being changed in the long battle for healthcare to become a right of all citizens.
https://www.washingtonpost.com/news/wonk/wp/2017/02/15/aetna-ceo-says-ob...
22
With the harsh reality of how divided Americans are on how to take care of the health of our most vulnerable in society, I would have to say our 240 year experiemt has come to an end.
We can not agree as a nation that healthcare is a right and that we need to see to it that every American citizen regardless of their economic position or age or disability MUST have healthcare.
The GOP has shown us time and time again they don't want to take care of our most vulnerable.
They want to offer "accessible" care. What if those who need it don't have "accessible" finances to pay for the plan that Paul Ryan and his family receive for life at the expense of US THE TAX PAYER?
Time to allow those who want to live under those rules to go and live a happy life of greed and selfishness.
While the rest of the country, minus those 62 million who didn't vote for this so-called president and his team of racist, bigots and billionaires can do just fine WITHOUT THEM.
Think about how nice that would be.
However, those 62 million would need a visa to come and visit the rest of us.
We can not agree as a nation that healthcare is a right and that we need to see to it that every American citizen regardless of their economic position or age or disability MUST have healthcare.
The GOP has shown us time and time again they don't want to take care of our most vulnerable.
They want to offer "accessible" care. What if those who need it don't have "accessible" finances to pay for the plan that Paul Ryan and his family receive for life at the expense of US THE TAX PAYER?
Time to allow those who want to live under those rules to go and live a happy life of greed and selfishness.
While the rest of the country, minus those 62 million who didn't vote for this so-called president and his team of racist, bigots and billionaires can do just fine WITHOUT THEM.
Think about how nice that would be.
However, those 62 million would need a visa to come and visit the rest of us.
21
Excellent article. Thank you.
17
Reminds me of Wyle E. Coyote going off the cliff... McConnell, Ryan et all have run out of road on repeal and replace.
12
How about the biggest lies, Mr. Leonhardt: "if you like your current insurance you can keep your insurance"; "If you like your current doctor, you can keep your current doctor"; "ACA will save each family $2500.00 in premium costs." All big lies by Obama. I guess those don't matter at all to a paritisan hack. But they sure mattered to millions of real people. (and I'm no fan of the repub bill either). Obamacare built on Romneycare was just a polical move to be able to blame Repubs for the failures of ACA, pure and simple. Medicare for all.
10
Just what did you think the republicans would do?
Now lets get back to Russiagate and do the world some good!
Now lets get back to Russiagate and do the world some good!
14
Donald Trump : " Who knew healthcare was so complicated ?"
President Obama knew.
President Obama knew.
32
Medicare, the universal health care plan for the elderly is extremely EXPENSIVE. It is NOT SUSTAINABLE with a growing elderly population and baby boomers not yet the cardiac patient at age 80. To have made that program available at age 55 would have been financial suicide. Harry Truman since 1945 was pushing a universal health care plan. Americans did not want socialism with healthcare and now we will pay for it. Healthcare increases 6.5% per year. Obviously Obama, the community organizer, lacked business acumen as do many socialistic democrats. They need a reality check. The democrats pushed thru Obamacare because they wanted to be the party who went down in history for giving it. They did not think about paying for it.
4
Republicans and Trump are stuck. They know they're stuck, but shockingly they don't care. Their solution is to hide their situation, and to hide their "solution", through obfuscation.
Republicans and zealots have used this tactic for centuries... if you can't convince people, confuse them.
And so republican TrumpCare is intentionally confusing. Is it ObamaCare 0.5? Is it healthcare at all? Or is it only a tax reduction? What is it really? No one knows. Not even the republicans. But they wanted to pass it quickly, before the CBO figured it out and told everyone! Then when they realized all republicans didn't agree with what it was, they started discrediting the CBO, in an offensive move. Well, the CBO has now told us about TrumpCare. And they said it was ugly. Hideous. Utterly repulsive. TrumpCare doesn't care about anyone, especially the poor and elderly. TrumpCare will harm 24 million people. But it will benefit even fewer millionaires. TrumpCare is illogical in a logical world -- it only makes sense if you're insane, or illiterate in logic.
So the solution is to let them enact it. Democrats should abstain from voting on their monstrosity. Let republicans slowly destroy their constituents.
Most importantly, ENSURE republicans cannot blame anyone else for this TrumpCare SHROUD they're putting over us.
Republicans and zealots have used this tactic for centuries... if you can't convince people, confuse them.
And so republican TrumpCare is intentionally confusing. Is it ObamaCare 0.5? Is it healthcare at all? Or is it only a tax reduction? What is it really? No one knows. Not even the republicans. But they wanted to pass it quickly, before the CBO figured it out and told everyone! Then when they realized all republicans didn't agree with what it was, they started discrediting the CBO, in an offensive move. Well, the CBO has now told us about TrumpCare. And they said it was ugly. Hideous. Utterly repulsive. TrumpCare doesn't care about anyone, especially the poor and elderly. TrumpCare will harm 24 million people. But it will benefit even fewer millionaires. TrumpCare is illogical in a logical world -- it only makes sense if you're insane, or illiterate in logic.
So the solution is to let them enact it. Democrats should abstain from voting on their monstrosity. Let republicans slowly destroy their constituents.
Most importantly, ENSURE republicans cannot blame anyone else for this TrumpCare SHROUD they're putting over us.
32
"On the other hand, if Republicans fail to pass their own bill, they’ll look weak and incompetent, which is also not a good look to voters"
When the GOP does something right, STOP humiliating them - APPLAUD THEM!
Tell readers instead that the GOP who vote against dangerous bills found their humanity or stood up for their constituents over the demands of Trump and corporate lobbies! If you embarrass those who do the right (ahem, correct) thing, they will feel like they have no allies on the Right or Left!
When the GOP does something right, STOP humiliating them - APPLAUD THEM!
Tell readers instead that the GOP who vote against dangerous bills found their humanity or stood up for their constituents over the demands of Trump and corporate lobbies! If you embarrass those who do the right (ahem, correct) thing, they will feel like they have no allies on the Right or Left!
5
I thought the original lie about Obamacare was "If you like your doctor you can keep your doctor."
8
TrumpCare? We should all begin calling it TrumpDon'tCare immediately.
22
Let's toast that day (may it come soon) when being a Republican no longer means detesting health care for ALL. Anyone listening to Obama from 2008 to 2010 AND SINCE THEN, heard him say many times that this (and all health care for everyone -- with the mandate for universal coverage) will be imperfect. It's not that having "Obamacare is sooo great", but it is that NOT having Obamacare is sooo awful. And when laced with "health care is primarily a good excuse to put $$$ into coffers of the wealthy", the outcome (are you listening Dr Price of Atlanta???) is a disaster and disgrace.
20
Listening to Sean Spicer, Kellyanne Conway and various surrogates try to "walk-back" Trumps wiretap comments are hilarious!
Most everything Trump says is a gross exaggeration or a blatant lie.
Even Ted Cruz (r) TX said Donald Trump is a pathological liar.
Most everything Trump says is a gross exaggeration or a blatant lie.
Even Ted Cruz (r) TX said Donald Trump is a pathological liar.
21
Once upon a time we used to joke about the rich man's problem with the full ashtray in his Cadillac. He would invariably junk the car and buy a new one.
The Republicans, it would appear, have a very flat learning curve: soon they'll be without ashtrays, wheels and windshields; and when they're seen on the windy streets they'll say: "It's all Obama's fault".
Liars all. Interested in their own private welfare.
"Qu'ils mangent de la brioche" We know where Marie Antoinette wound up. Republicans, especially Trump Ryan, McConnell, Spicer, Price and Conway = cold-hearted monsters.
The Republicans, it would appear, have a very flat learning curve: soon they'll be without ashtrays, wheels and windshields; and when they're seen on the windy streets they'll say: "It's all Obama's fault".
Liars all. Interested in their own private welfare.
"Qu'ils mangent de la brioche" We know where Marie Antoinette wound up. Republicans, especially Trump Ryan, McConnell, Spicer, Price and Conway = cold-hearted monsters.
16
The Republicans, including Tom Price, a doctor, are not representing anything medical about their proposal in their new healthcare plan.
They claim their proposal is "patient centered" but do not explain their idea of what that is.
They try to give the illusion that their plan will give "full coverage" but don't explain.
I felt like throwing a shoe at the TV when Sean Spicer was speaking to their healthcare plan yesterday. As a nurse for years that truly has dealt with real patient "care plans" these men are oblivious to disease, disease process, and yes "care plans".
Can you imagine if every single person who needs health insurance would have their own personal health insurance plan written special for them? Insurance is a pool, a pool made up of risks and non risks, not picking diseases here and there and then the insurance writing up your own plan.
What? They think insurances are going to provide "the diabetes plan" or "the cancer plan" or "the multiple sclerosis plan"? Maybe "the cardiac plan" or the orthopedic plan"?
Here's one - how about the "black lung plan"? The ACA mandated coverage for black lung - and now the very people who voted for Trump, afflicted with black lung, are anxious and angry because guess what? The Republican plan doesn't include "the black lung mandate plan"!
The Republican verbiage is a big fat lie about getting coverage.
They'll try to cover their lies saying it is the CBO who lied!
Well, to only 24 million. Right?
They claim their proposal is "patient centered" but do not explain their idea of what that is.
They try to give the illusion that their plan will give "full coverage" but don't explain.
I felt like throwing a shoe at the TV when Sean Spicer was speaking to their healthcare plan yesterday. As a nurse for years that truly has dealt with real patient "care plans" these men are oblivious to disease, disease process, and yes "care plans".
Can you imagine if every single person who needs health insurance would have their own personal health insurance plan written special for them? Insurance is a pool, a pool made up of risks and non risks, not picking diseases here and there and then the insurance writing up your own plan.
What? They think insurances are going to provide "the diabetes plan" or "the cancer plan" or "the multiple sclerosis plan"? Maybe "the cardiac plan" or the orthopedic plan"?
Here's one - how about the "black lung plan"? The ACA mandated coverage for black lung - and now the very people who voted for Trump, afflicted with black lung, are anxious and angry because guess what? The Republican plan doesn't include "the black lung mandate plan"!
The Republican verbiage is a big fat lie about getting coverage.
They'll try to cover their lies saying it is the CBO who lied!
Well, to only 24 million. Right?
36
The basic features of the ACA were thought up by conservatives, promoted by the Heritage Foundation, and first implemented by a Republican governor in Massachusetts – a guy named Romney.
Here's one of the documents from the Heritage Foundation:
http://thf_media.s3.amazonaws.com/1989/pdf/hl218.pdf
Republicans would never admit this, but if the ACA in its exact current form been signed by George W. Bush, no one would be asking for its repeal. Opposition to the ACA is just a battering ram for opposition to progressive policy in general. Pure politics. 70% of Americans, those covered by employer insurance or Medicare, are not even affected by the law,
Here's one of the documents from the Heritage Foundation:
http://thf_media.s3.amazonaws.com/1989/pdf/hl218.pdf
Republicans would never admit this, but if the ACA in its exact current form been signed by George W. Bush, no one would be asking for its repeal. Opposition to the ACA is just a battering ram for opposition to progressive policy in general. Pure politics. 70% of Americans, those covered by employer insurance or Medicare, are not even affected by the law,
34
Have you all forgotten the definition of "Red State"
A "Red State" is -- yes do the fact check --
A "Red State" is a state the takes more money from the Federal Government than they pay in taxes to the Feds.
That is the definition of a "Red State"
Only Texas is an exception (as always).
Why do "Red State" politicians scream about socialism, small government ??
Heh Heh. Cause they are rippiing the "Blue states" off.
A "Red State" is -- yes do the fact check --
A "Red State" is a state the takes more money from the Federal Government than they pay in taxes to the Feds.
That is the definition of a "Red State"
Only Texas is an exception (as always).
Why do "Red State" politicians scream about socialism, small government ??
Heh Heh. Cause they are rippiing the "Blue states" off.
38
Well, we all know the truth. No one is fooling anyone. Trumpsters know the truth, but they are very willing to subvert their very own best interests for the unspoken promise embedded within Trumpism that the country can be purged of anyone that does not look and think and believe and love like they do. So far. They are starting to get a little antsy, so look for diversionary tactics to get them back in line soon. Unfortunately that most probably means warmongering.
In the meantime, we liberals must all admit that, amid all the horror of watching republicans screw up healthcare, it's hysterical watching them cornered into delivering some form of socialism - and it drives them NUTS. The catharsis for the nation through all this is that the absurdity of not having national healthcare is becoming more stark. Likely this sturm und drang gets us there sooner than we might think possible. Obama is smiling.
In the meantime, we liberals must all admit that, amid all the horror of watching republicans screw up healthcare, it's hysterical watching them cornered into delivering some form of socialism - and it drives them NUTS. The catharsis for the nation through all this is that the absurdity of not having national healthcare is becoming more stark. Likely this sturm und drang gets us there sooner than we might think possible. Obama is smiling.
11
That so many people will lose health coverage and the wealthy will profit yet again and it's all been carefully planned by a morally corrupt republican congress that doesn't give a damn is bad enough. That Trump & Co. will lie about the numbers (as Price is already doing) and try to discredit the CBO and blame it all on Obama and hollar "fake news!!" and insist that what we claim to see and hear is not really what is happening compounds the misery. And the Trump lovers won't believe in it until it actually does happen and swallow any lie he tells them about how its somebody else's fault. And sometime soon we'll be treated to a photograph of a bunch of grinning and applauding white men in suits standing around a desk while Trump triumphantly signs the bill. Meanwhile, in the next few days, we wait with dread and baited breath to see what calamity or injury to himself Trump will invent to try to distract our attention, only to claim a week or ten days later that the words he did indeed say were not the words he actually said, with every confidence that we're stupid enough to believe it. And the shameless republican-led congress will be trotting out the next outrage and the whole cycle begins again.
Will someone please remind me why Hillary Clinton would have been worse?
Will someone please remind me why Hillary Clinton would have been worse?
25
All the facts in the world won't change the view of conservatives whose biased 'news' sources have fed them easy to remember lines. The lie that Obama rammed Obamacare through Congress. The misquote that Pelosi said you have to pass it to see what's in it. The irrelevant trivia that it was passed at midnight. The fiction that it's a disaster. Republicans continually win the messaging war in an alliance between perfidious party leaders, complicit media and incurious, fearful and at times hateful supporters.
21
I suspect, that despite much pleading by consumers, the two NC Senators, Burr and Tillis (the good ole party boys that they are) will vote for trumpcare, under the guise that it will be "fixed".
It won't be fixed, millions will lose healthcare, people will go into bankruptcy trying to pay for healthcare and people will die.
And meanwhile trump (math genius that he is) disputes the figures put out by the Congressional Budget Office. Then he'll jet off to Florida to play golf and massage his bruised ego. So much for healthcare for all.
It won't be fixed, millions will lose healthcare, people will go into bankruptcy trying to pay for healthcare and people will die.
And meanwhile trump (math genius that he is) disputes the figures put out by the Congressional Budget Office. Then he'll jet off to Florida to play golf and massage his bruised ego. So much for healthcare for all.
15
The Republican bill is what you get when you start believing your own baloney and the FOX News baloney and start seeing unicorns on the Rose Garden. This bill is the baby of Paul Ryan and every other Republican who believes that the free market and Aym Rand's philosophy of every man, woman and child for themselves is the solution to mankind's "ills."
It is curious, isn't it, that we don't conduct war as individuals. We do it as a community. Healthcare is a war against disease and death. It too cannot be conducted by individuals and must be done by the entire society -- together -- in order to save the largest number of us in the most humane way possible.
I don't believe that the parents of these Republicans threw them out in infancy to fend for themselves, so where did they learn their anti-human lessons? It's for sure they no longer have any of the common sense that God gave them.
It is curious, isn't it, that we don't conduct war as individuals. We do it as a community. Healthcare is a war against disease and death. It too cannot be conducted by individuals and must be done by the entire society -- together -- in order to save the largest number of us in the most humane way possible.
I don't believe that the parents of these Republicans threw them out in infancy to fend for themselves, so where did they learn their anti-human lessons? It's for sure they no longer have any of the common sense that God gave them.
23
I don't understand the title. What lie? People expected free! It costs - in every country. Through taxes. Only a small percentage of people face rate increase - rates as low as $50 increase to $100 - you pay more for Medicareart B! Truthful reporting would have changed the election. We are stuck with this - sad but true.
6
I am saving this Op-Ed piece. It is a good recap of the evolution of government sponsored healthcare to date. There are a lot of alternative narratives out there, and I want to have this handy for future reference.
10
On the contrary- when has "believing your own alternative facts" failed the Republican party over the last 15+ years? They hold all elements of the Federal government and most of the governorships and state houses in the country.
"Believing your own alternative facts" seems to be working out quite well!
We live in a post-fact world, it seems. God help us.
"Believing your own alternative facts" seems to be working out quite well!
We live in a post-fact world, it seems. God help us.
11
Bipartisan or not, the ACA is a wretched union of Government Incompetence and Corporate Malfeasance. The only way to improve medical service delivery in the U.S. is to have some kind of Single Payer program along the lines of the French or German system, or perhaps the Canadian System. That plus a provision for concierge medical care for those that can afford to pay for it out of pocket.
Obama and the Democrats did not have the courage to take the rational course and they have hung a bad compromise around our necks like a millstone.
Obama and the Democrats did not have the courage to take the rational course and they have hung a bad compromise around our necks like a millstone.
5
Republicans hated Obama so much that they could not support what was "Republican health reform," because they were more concerned with making sure that Obama was a one term president. Now they are stuck with the consequences of their vilification. If they had never called it "Obamacare" but left it as the ACA, they might have been able to live with it with a few more Republican tweaks. But now they want to wipe Obama out of history. And the conservative hawks are now in charge, and they just no longer want to spend tax money on health care for poor people. They just do not care whether these people live or prematurely die.
16
Here are three things that should ALWAYS be part of the rebuttals of GOP lies about health care...
1. All other advanced democracies cover everyone.
2. All other advanced democracies do so on a much cheaper per capita basis.
3. Almost all other advanced democracies have better health outcomes.
GOP health policy dysfunction is a result of...
1. Lies they knowingly tell (Tom Price: Everyone who wants insurance will get it under the Trump/Ryan/Price plan)...
2. A warped and dangerous ideology (Paul Ryan: The guy who STILL has not outgrown his late adolescent Ayn Rand crush).
3. Sheer ignorance (Most of the GOP house members out in the media seem to truly believe various things that are demonstrably false--that the U.S. has the best health care system, Canadians an Europeans are coming in hoards to the U.S. to escape their 'terrible' health care systems, all we need to do in the heath insurance sector is get government out and the market will provide insurance to all, etc.). From those of us in the reality based world, LOL. They seems to lack even an elementary understanding of the most basic realities of how health insurance works.
4. Gross misperception (Ryan believes that millions are 'forced' to buy health insurance by ACA. This is false. Most who really do not want insurance simply pay the tax penalty, which is much cheaper than unsubsidized health plans on the exchanges.)
1. All other advanced democracies cover everyone.
2. All other advanced democracies do so on a much cheaper per capita basis.
3. Almost all other advanced democracies have better health outcomes.
GOP health policy dysfunction is a result of...
1. Lies they knowingly tell (Tom Price: Everyone who wants insurance will get it under the Trump/Ryan/Price plan)...
2. A warped and dangerous ideology (Paul Ryan: The guy who STILL has not outgrown his late adolescent Ayn Rand crush).
3. Sheer ignorance (Most of the GOP house members out in the media seem to truly believe various things that are demonstrably false--that the U.S. has the best health care system, Canadians an Europeans are coming in hoards to the U.S. to escape their 'terrible' health care systems, all we need to do in the heath insurance sector is get government out and the market will provide insurance to all, etc.). From those of us in the reality based world, LOL. They seems to lack even an elementary understanding of the most basic realities of how health insurance works.
4. Gross misperception (Ryan believes that millions are 'forced' to buy health insurance by ACA. This is false. Most who really do not want insurance simply pay the tax penalty, which is much cheaper than unsubsidized health plans on the exchanges.)
15
I suspect, that despite much pleading by consumers, the two NC Senators, Burr and Tillis (the good ole party boys that they are) will vote for trumpcare, under the guise that it will be "fixed".
It won't be fixed, millions will lose healthcare, people will go into bankruptcy trying to pay for healthcare and people will die.
And meanwhile trump (math genius that he is), disputes the figures put out by the Congressional Budget Office. Then he'll fly off to Florida to play golf and massage his bruised ego. So much for healthcare for all.
It won't be fixed, millions will lose healthcare, people will go into bankruptcy trying to pay for healthcare and people will die.
And meanwhile trump (math genius that he is), disputes the figures put out by the Congressional Budget Office. Then he'll fly off to Florida to play golf and massage his bruised ego. So much for healthcare for all.
5
Paul Ryan and his second-rate understanding of socialism is something we need to get rid of. Socialism is simply using government to help all of us more efficiently than any private system can. Guess what? The advanced nations of the world have discovered this. The brain cells of too many Americans work very slowly and enable Ryan to have traction he doesn't deserve. It's time this second-rate huckster and his backward plan were dismissed as the frauds that they are.
23
Finally someone addressed the biggest lie. "Obama rammed this through", lie. I can't remember a President who tried harder to be inclusive. He appointed GOP to his cabinet, attempted to have a "big tent"; was slapped away at every turn, from the first night of his presidency on. Obama divisive? The only divisiveness was from the other side and that lasted 8 years. People saw it though, finally, and thus Obama had 60% approval ratings as he left office. He was a class act and the antithesis of the Groper in the WH now. Wait a few more months, most sane Trump voters will be regretting what they wrought. Some on this page already are saying the ridiculous about the intent with Obamacare. "It was a political decision meant to benefit as many as they could while signing them up as loyal Democratic voters." Here's the problem. Democrats truly believe that all Americans deserve affordable health care, i.e. Single Payer. We don't really care whether you are a democrat or republican. We are happy to get more votes but ultimately, we care more about fairness and making sure we secure our stature as a true democracy. The other side truly doesn't get us and really puts us into deplorable baskets; and the baskets they like are the ones with money to line their pockets. Some commenters can't comprehend that Dems believe that humanity and kindness are more important than the bottom line. That's the difference between us and them. And I'm proud to stand with us, no matter what the cost.
19
To parody Herr Luettgen's rant about artificially distorting markets --
The flaw manifestly on display in "Trumpcare" and "Ryancare" is --
If you push too much public money into supporting 20%-40% net profits for "Big Pharma" and "Big Insurers" and "Big Healthcare" -- eventually this messing with free markets will have to crash. Paying 2-3 times the world price for healthcare to support the established beneficiaries of congressional largesse to donors and lobbyists is not sustainable.
The ongoing subsidies to corporate donor's interests are ' bound to crash and burn as its contradictions played out, as its myriad, poorly-synchronized moving parts started breaking down '
The flaw manifestly on display in "Trumpcare" and "Ryancare" is --
If you push too much public money into supporting 20%-40% net profits for "Big Pharma" and "Big Insurers" and "Big Healthcare" -- eventually this messing with free markets will have to crash. Paying 2-3 times the world price for healthcare to support the established beneficiaries of congressional largesse to donors and lobbyists is not sustainable.
The ongoing subsidies to corporate donor's interests are ' bound to crash and burn as its contradictions played out, as its myriad, poorly-synchronized moving parts started breaking down '
8
Exactly. They helped build it, then ran away for purely political purpose and sold the notion it was horrible. Obama had always allowed that he was willing to improve it, if only provided a means to do so by Republicans. States too were provided that choice. Crickets.
Trumpcare can't be made pretty with a fantastical comb over. Ryan is no longer the smartest guy in the room by affirmation. It will never pass.
Next.
Trumpcare can't be made pretty with a fantastical comb over. Ryan is no longer the smartest guy in the room by affirmation. It will never pass.
Next.
15
"Lying can be an effective political tactic." At the same time, lying is an ineffective strategy because ultimately the truth will come out and the lies will be ashes in the mouths of the mendacious.
The Republicans will see approval become opprobrium. Sure, everyone would love to believe health care would be cheaper, better and universal under the Ryan-Trump plan just as we would love to believe:
--cold fusion is a limitless source of energy
--there is such a thing as a free lunch
--you can lose weight while sleeping with this herbal supplement
--of course, I will respect you in the morning
Well, I might respect you but not the Republicans. And one more thing: I vote. Regularly. You can believe that.
The Republicans will see approval become opprobrium. Sure, everyone would love to believe health care would be cheaper, better and universal under the Ryan-Trump plan just as we would love to believe:
--cold fusion is a limitless source of energy
--there is such a thing as a free lunch
--you can lose weight while sleeping with this herbal supplement
--of course, I will respect you in the morning
Well, I might respect you but not the Republicans. And one more thing: I vote. Regularly. You can believe that.
9
When some Republicans call coverage "welfare" then it becomes evident that such people want any coverage in the hands of big insurance companies.
These Republicans push any issue (such as our health) into the arena of "business".
What would it take for our congress to offer the same approach found in our European (and Australian) allies? Why not? Well, just the use of the word, socialism, has them screaming ...But the typical European is covered.
The GOP Plan excludes millions of Americans.
Hence, millions should protest.
These Republicans push any issue (such as our health) into the arena of "business".
What would it take for our congress to offer the same approach found in our European (and Australian) allies? Why not? Well, just the use of the word, socialism, has them screaming ...But the typical European is covered.
The GOP Plan excludes millions of Americans.
Hence, millions should protest.
14
It is obvious that the Evil Republicans want to reduce health care costs by reducing health care to the masses. More dead constituents mean less health care cost.
Why don't the people that vote for these Ugly Americans see through the hype?
Medicare for all.
Why don't the people that vote for these Ugly Americans see through the hype?
Medicare for all.
13
The U.S. is a great place to be rich and a terrible place to be poor -- and now, even middle class. We have a national administration "of the rich, by the rich, and for the rich." The reason so many Americans vote for these guys is because they hate people of color, who they are sure are sucking the life out of the country and living off the taxpayers' bounty. No reasoned argument demonstrating the untruth of this view has any effect on them. So be it.
20
Republicans are choking on their own hatred. From day one they hated the audacity of a black man being President. It didn't matter if it was health care, the environment or nuclear proliferation.
They hated that the upstart Obama was smarter than them and had more grace and integrity than they did.
So Obamacare in an ironic and unexpected way did more than cover millions of uninsured, it may cause a final resting place for the far right. Let's hope so.
They hated that the upstart Obama was smarter than them and had more grace and integrity than they did.
So Obamacare in an ironic and unexpected way did more than cover millions of uninsured, it may cause a final resting place for the far right. Let's hope so.
18
“How did the party’s leaders put themselves in this position? The short answer is that they began believing their own hype and set out to solve a problem that doesn’t exist…Lying can be an effective political tactic. Believing your own alternative facts, however, is usually not so smart.”
Solving problems that don't exist: a Republican specialty. Add this to the list that includes voter fraud, Mexican terrorists, welfare drug testing, etc.
Solving problems that don't exist: a Republican specialty. Add this to the list that includes voter fraud, Mexican terrorists, welfare drug testing, etc.
17
The insurance middleman is a giant suck on society. Money changes hands for no real product. This is tied to our manufacturing job losses, our trade deficits, and much else of what's wrong with us. We are trading money with each other, then sending it overseas. Let's work together instead of against each other.
12
The simple fact is that ObamaCare is modeled on RomneyCare instituted here in Massachusetts in 2006 by Governor Mitt Romney, which itself is based on a and incorporates many ideas presented in a 1989 paper from the very conservative Heritage Foundation.
The Republicans object to ObamaCare just as the object to every bill that Obama signed because Obama has more melanin than they do.
They are a bunch of bigots who are still (unsuccessfully) trying to accomplish what Mitch McConnell publicly stated as their goal: to make President Obama a one term President.
Rather, they might be making Emperor Donnie a one term "so-called President." He is doing his very best to violate every Constitutional, contractual and ethical provision that he possibly can. He also lies a great deal. We are definitely NOT winning yet.
The Republicans object to ObamaCare just as the object to every bill that Obama signed because Obama has more melanin than they do.
They are a bunch of bigots who are still (unsuccessfully) trying to accomplish what Mitch McConnell publicly stated as their goal: to make President Obama a one term President.
Rather, they might be making Emperor Donnie a one term "so-called President." He is doing his very best to violate every Constitutional, contractual and ethical provision that he possibly can. He also lies a great deal. We are definitely NOT winning yet.
26
Well written David.
You corrected parsed what is going on in this country now.
On the right, you have die hard ideological zealots who believe that health care is a privilege and not a right and retreat into a bunker fighting any national health plan that is not pure free enterprise even if 300 millions Americans cannot afford it.
On the left, instead of nominating a candidate like Bernie who shifted from socialist to moderate progressive, we put up Hillary, a far left, identity party candidate who gave the election to Trump, somebody she was supposed to beat.
Learn from history or forever be condemned to repeat its worst aspects.
You corrected parsed what is going on in this country now.
On the right, you have die hard ideological zealots who believe that health care is a privilege and not a right and retreat into a bunker fighting any national health plan that is not pure free enterprise even if 300 millions Americans cannot afford it.
On the left, instead of nominating a candidate like Bernie who shifted from socialist to moderate progressive, we put up Hillary, a far left, identity party candidate who gave the election to Trump, somebody she was supposed to beat.
Learn from history or forever be condemned to repeat its worst aspects.
6
What's in a name? The original mistake Obama made was titling the bill the Affordable Care Act, and then let the Republicans get away with calling it "Obamacare" which was a toxic name to many of their base. Instead, the act should have been Labeled Romneycare from the start, or at least been loudly and publically nickname Romneycare at every opportunity. Remind Republicans that one of their own, one who they ran for President, oversaw its birth. I personally believe that would have made it much more popular and harder to run against politically.
That said, I also believe the only solution to healthcare in this country is to model us after most of the rest of the civilized world that cuts insurance for profit out of the picture. Think Canada, Europe, etc.
That said, I also believe the only solution to healthcare in this country is to model us after most of the rest of the civilized world that cuts insurance for profit out of the picture. Think Canada, Europe, etc.
27
Young Mr. Leonhardt? You do realize that all of us with employer-provided insurance are not in the ACA marketplace, and thus we have no skin in the game as far as providing health insurance to the neediest? We are trying to balance the needs of the medically needy old, the medically needy young, and all of the medically needy children and babies on the backs of those not working or not lucky enough to get insurance through work.
You understand that part of it, right? The mandate pinned all of the fiscal responsibility on the portion of the population engaged in self employment, or self ownership of a business that does not provide insurance for employees. This was rigged to fail from the start: trying to have the healthiest and most independent, who likely can walk away from health insurance coverage for several years, support all those unlucky enough to be sickly and uninsured.
Unless journalist-advocates like yourself have to help pay for the medically needy outside of your own employer's insurance pools, you're not going to fix the system. There just isn't enough money for the healthy to pay for the sick.
Too bad we don't tax Big Sugar, Big Pharma, or Big Tobacco to pay directly for people's health from the profits they are taking, instead of penalizing the healthy via a "Health Penalty" for being too healthy and independent and forgoing insurance and taking care of oneself and one's own.
At least President Trump took away the crippling Health Penalty...
You understand that part of it, right? The mandate pinned all of the fiscal responsibility on the portion of the population engaged in self employment, or self ownership of a business that does not provide insurance for employees. This was rigged to fail from the start: trying to have the healthiest and most independent, who likely can walk away from health insurance coverage for several years, support all those unlucky enough to be sickly and uninsured.
Unless journalist-advocates like yourself have to help pay for the medically needy outside of your own employer's insurance pools, you're not going to fix the system. There just isn't enough money for the healthy to pay for the sick.
Too bad we don't tax Big Sugar, Big Pharma, or Big Tobacco to pay directly for people's health from the profits they are taking, instead of penalizing the healthy via a "Health Penalty" for being too healthy and independent and forgoing insurance and taking care of oneself and one's own.
At least President Trump took away the crippling Health Penalty...
34
Capitalism died when Repubs denied a real competitive insurance market, allowing med-ins to be a product like other forms of insurance, sold across state lines, forming general population pools, etc. Capitalism died when the Repubs claimed themselves its sole priesthood and protector. Capitalism died when it was deemed more favorable to strip wealth from the larger, more consumptive middle-lower classes, and hand it all to 1-3% of the population.
However another huge problem is that Democrats simply stink at countering the Republican narratives. Allowing the Repubs to lie about just about everything. Then expect citizens, be they Democrat or other, to go figure it all out on their own. They allow the Repub lies to fester and spawn, instead of actively and clearly knocking them down. Leaving it to columns like this one to fix the record. But the problem is, its preaching to the choir, because the people who need to read this/others - are not!
Its imperative the Democrats get out and set the record straight, get out and always counter the Repub lies and obfuscations. Made more important with a disingenuous, lying, false-accuser occupying the Oval.
I received an email today from the White House, asking me for my ACA horror story to add to their PR push. Why didnt my Democratic reps send me one to counter that propaganda gathering? Or send one much like this/other columns countering the ACA lies, while also dissecting the TrumpRyan-care plan?
Arrgg! The Dems!
However another huge problem is that Democrats simply stink at countering the Republican narratives. Allowing the Repubs to lie about just about everything. Then expect citizens, be they Democrat or other, to go figure it all out on their own. They allow the Repub lies to fester and spawn, instead of actively and clearly knocking them down. Leaving it to columns like this one to fix the record. But the problem is, its preaching to the choir, because the people who need to read this/others - are not!
Its imperative the Democrats get out and set the record straight, get out and always counter the Repub lies and obfuscations. Made more important with a disingenuous, lying, false-accuser occupying the Oval.
I received an email today from the White House, asking me for my ACA horror story to add to their PR push. Why didnt my Democratic reps send me one to counter that propaganda gathering? Or send one much like this/other columns countering the ACA lies, while also dissecting the TrumpRyan-care plan?
Arrgg! The Dems!
253
Obamacare could never succeed. Healthcare is a body of products and services that others must produce. Therefore healthcare can't be a "right." No one can claim products and services (work) of others as a right. When progressive liberal Marxist democrats say it is, they simply mean that some must work for others, which is slavery. Obamacare is as immoral as slavery...that is why Obamacare is failing.
Healthcare is over regulated. FDA should not be in a position to approve or deny anything. FDA should simply monitor and report facts while promoting good practices. More than 4000 generic drugs sit awaiting "FDA approval." Those drugs could be helping people, but each day they sit waiting for pinheads to decide for you raises their cost for all.
Tear down this regulatory regime and liberate people and markets. Forced charity isn't charity and insurance isn't healthcare.
Healthcare is over regulated. FDA should not be in a position to approve or deny anything. FDA should simply monitor and report facts while promoting good practices. More than 4000 generic drugs sit awaiting "FDA approval." Those drugs could be helping people, but each day they sit waiting for pinheads to decide for you raises their cost for all.
Tear down this regulatory regime and liberate people and markets. Forced charity isn't charity and insurance isn't healthcare.
3
All this analysis is borderline silly. Ryan and the GOP are puppets doing their handlers’ bidding.
The U.S. is officially in the hands of a handful of out-or-control money and power addicts who use bank balances and the manipulation of puppets in their “think” tanks, the media, and in congress to trigger the same dopamine junkies trigger with heroin. The difference is that when junkies get carried away trying to satisfy insatiable neurological cravings they kill themselves while money/power addicts’ obsessive need to score more than they need or can use end up killing innocent victims.
There’s no way to make sense of an entire party heartlessly destroying the lives of millions of constituents they supposedly represent. But when you realize they’re actually just a bunch of addicts obsessively feeding addictive needs (by pimping themselves out for the bribes they pretend are contributions that get them elected) suddenly the lying, cheating, heartlessness, hypocrisy, and inane excuses make sense.
Addicts have one ideology and it’s to score the next fix. And just as junkies will gladly steal and sell strangers and even family members’ possessions to score, we have elected officials selling their minds, souls, and votes to the highest bidders to satisfy addictive cravings.
DopamineProlject.org
The U.S. is officially in the hands of a handful of out-or-control money and power addicts who use bank balances and the manipulation of puppets in their “think” tanks, the media, and in congress to trigger the same dopamine junkies trigger with heroin. The difference is that when junkies get carried away trying to satisfy insatiable neurological cravings they kill themselves while money/power addicts’ obsessive need to score more than they need or can use end up killing innocent victims.
There’s no way to make sense of an entire party heartlessly destroying the lives of millions of constituents they supposedly represent. But when you realize they’re actually just a bunch of addicts obsessively feeding addictive needs (by pimping themselves out for the bribes they pretend are contributions that get them elected) suddenly the lying, cheating, heartlessness, hypocrisy, and inane excuses make sense.
Addicts have one ideology and it’s to score the next fix. And just as junkies will gladly steal and sell strangers and even family members’ possessions to score, we have elected officials selling their minds, souls, and votes to the highest bidders to satisfy addictive cravings.
DopamineProlject.org
11
The media deserve a lot of blame, as well. When the Clintons tried to reform health care financing, and then again when the ACA was being fashioned, it was essential to explain the concept of managed competition to the American people. But this was apparently considered too "wonky" and the fear was that ratings and circulation would be hurt by something that was not simple and entertaining. Here is a seminal paper about managed competition. No one who has not read this paper is entitled to have an opinion worthy of respect about "Hillarycare" or "Obamacare."
http://content.healthaffairs.org/content/12/suppl_1/24.abstract
http://content.healthaffairs.org/content/12/suppl_1/24.abstract
6
Hold this so-called president aka Putins puppet accountable.
In his own words:
"There's many different ways, by the way. Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, 'No, no, the lower 25 percent that can't afford private'… I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now."
When Mr. Pelley asked Mr. Trump how his health law would care for the uninsured, Mr. Trump said, "the government's gonna pay for it. But we're going to save so much money on the other side. But for the most it's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything."
At a Republican rally in New Hampshire in February, Mr. Trump said negotiating with pharmaceutical companies could reap huge savings, according to Fortune.
The candidate said, "Because the drug companies have an unbelievable lobby. And these guys that run for office, that are on my left and right and plenty of others, they're all taken care of by the drug companies. And they're never going to put out competitive bidding. So I said to myself wow, let me do some numbers. If we competitively bid, drugs in the United States, we can save as much as $300 billion a year."
In his own words:
"There's many different ways, by the way. Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, 'No, no, the lower 25 percent that can't afford private'… I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now."
When Mr. Pelley asked Mr. Trump how his health law would care for the uninsured, Mr. Trump said, "the government's gonna pay for it. But we're going to save so much money on the other side. But for the most it's going to be a private plan and people are going to be able to go out and negotiate great plans with lots of different competition with lots of competitors with great companies and they can have their doctors, they can have plans, they can have everything."
At a Republican rally in New Hampshire in February, Mr. Trump said negotiating with pharmaceutical companies could reap huge savings, according to Fortune.
The candidate said, "Because the drug companies have an unbelievable lobby. And these guys that run for office, that are on my left and right and plenty of others, they're all taken care of by the drug companies. And they're never going to put out competitive bidding. So I said to myself wow, let me do some numbers. If we competitively bid, drugs in the United States, we can save as much as $300 billion a year."
9
We, as a Country, should never have gotten to this point with Healthcare and the rise of Trump. Republicans are responsible for the lion share of this mess, but Democrats and the mainstream media share some of this blame as well.
Low information Voters, disgruntled white voters in the heartland, and apathetic Democrats who stayed home all contributed to Trump's victory. Why? Because they blamed both parties for the gridlock in Washington. The consensus was that somebody needed to 'shake things up', even if it called for a wildly incompetent and flawed candidate to be that person.
This inferno we face had it's origins in small brushfires with the Tea Party/Republicans in '09 blaming Obama for the deficit. Later, those same groups shut down the Government, held up votes on the debt ceiling, and passed 61 bills to repeal Obamacare.
What did the Democrats do? Nothing ! For example, after each of the 61 votes to repeal Obamacare, did the President and Democratic Leaders challenge Republicans to 'show their alternative'? Did Obama raise the prospect of Social Security checks being held up if the Government shut down? No, again.
The Republicans and 'boy genius' Paul Ryan never had an alternative Health Care plan waiting in the wings. And Democrats and the Media let them get away with that fiction. Finally, finally, the truth is revealed. Too late my friends. Should have put that fire a long time ago.
Low information Voters, disgruntled white voters in the heartland, and apathetic Democrats who stayed home all contributed to Trump's victory. Why? Because they blamed both parties for the gridlock in Washington. The consensus was that somebody needed to 'shake things up', even if it called for a wildly incompetent and flawed candidate to be that person.
This inferno we face had it's origins in small brushfires with the Tea Party/Republicans in '09 blaming Obama for the deficit. Later, those same groups shut down the Government, held up votes on the debt ceiling, and passed 61 bills to repeal Obamacare.
What did the Democrats do? Nothing ! For example, after each of the 61 votes to repeal Obamacare, did the President and Democratic Leaders challenge Republicans to 'show their alternative'? Did Obama raise the prospect of Social Security checks being held up if the Government shut down? No, again.
The Republicans and 'boy genius' Paul Ryan never had an alternative Health Care plan waiting in the wings. And Democrats and the Media let them get away with that fiction. Finally, finally, the truth is revealed. Too late my friends. Should have put that fire a long time ago.
14
You note: "Obamacare IS the bipartisan version of health reform. It accomplishes a liberal end through conservative means and is much closer to the plan conservatives favored a few decades ago than the one liberals did."
Yes. And I simply can't understand why the Ds did not join the battle and repeatedly make this point. If the Rs want to cover preexisting conditions and not have the emergency room serve as the primary care physician for millions of Americans, it was time for them to work with the Ds and fix practical problems, in light of experience, with this substantively bipartisan approach. They could even have worked to make the bill more to their liking before it passed.
I wish you or Edsall or Howard Dean or someone could explain to me why the Ds did not continually make this point. The Rs constantly pummeled them over health care for political advantage and they did not join the battle.
Muhammad Ali managed to pull off his rope-a-dope strategy when he fought George Foreman, but I don't think the Ds are as good at politics as Ali was at boxing. The election of Trump, R majorities in both houses of Congress, and R strength in state governments sounds to me like this particular rope-a-dope strategy didn't work out so well.
In between doing nothing and shouting down or shaming your opponents there's the option of aggressively defending your positions and explaining why you have good ideas.
Yes. And I simply can't understand why the Ds did not join the battle and repeatedly make this point. If the Rs want to cover preexisting conditions and not have the emergency room serve as the primary care physician for millions of Americans, it was time for them to work with the Ds and fix practical problems, in light of experience, with this substantively bipartisan approach. They could even have worked to make the bill more to their liking before it passed.
I wish you or Edsall or Howard Dean or someone could explain to me why the Ds did not continually make this point. The Rs constantly pummeled them over health care for political advantage and they did not join the battle.
Muhammad Ali managed to pull off his rope-a-dope strategy when he fought George Foreman, but I don't think the Ds are as good at politics as Ali was at boxing. The election of Trump, R majorities in both houses of Congress, and R strength in state governments sounds to me like this particular rope-a-dope strategy didn't work out so well.
In between doing nothing and shouting down or shaming your opponents there's the option of aggressively defending your positions and explaining why you have good ideas.
6
t rump campaigned on the idea that only he could solve problems only he could see.
That is a general malaise of the republican party. One that starts with their new found (3 decades old) hatred of democracy.
It makes me very sad to think that my countrymen/women have become so small, so mean, so intolerant that they would elect the so called president and keep electing the so called people like McConnell and Ryan. Many of their most virulent supporters are lost, but not all who voted republican while holding their noses are lost.
We might reach them by pointing out that their Savior (many of them anyway) was the ultimate bleeding heart liberal.
What would Jesus do?
Well, according to the book that right wing so called Christians quote like it was Scripture, we know what Jesus did:
He healed the sick.
He fed the hungry.
He visited the prisoner.
He clothed the naked.
He tended the poor.
He threw the bankers and merchants out of the temple.
He forgave those who tortured and murdered him.
He did all that with love and compassion, not with self-righteous judgement.
He did exactly the opposite of what these so called Christians in the republican party are doing.
It might work.
That is a general malaise of the republican party. One that starts with their new found (3 decades old) hatred of democracy.
It makes me very sad to think that my countrymen/women have become so small, so mean, so intolerant that they would elect the so called president and keep electing the so called people like McConnell and Ryan. Many of their most virulent supporters are lost, but not all who voted republican while holding their noses are lost.
We might reach them by pointing out that their Savior (many of them anyway) was the ultimate bleeding heart liberal.
What would Jesus do?
Well, according to the book that right wing so called Christians quote like it was Scripture, we know what Jesus did:
He healed the sick.
He fed the hungry.
He visited the prisoner.
He clothed the naked.
He tended the poor.
He threw the bankers and merchants out of the temple.
He forgave those who tortured and murdered him.
He did all that with love and compassion, not with self-righteous judgement.
He did exactly the opposite of what these so called Christians in the republican party are doing.
It might work.
16
A life-long liberal, I am now in favor of letting the victors accomplish what they were elected to do. Given the Executive branch and both houses of Congress, the Republicans need to forge ahead -- alone and without Democratic support -- to pass their health care bill into law. Let the chips fall where they may and let the Republicans face the consequences. Will this hurt many people along the way? Yes. Of course it will. But about half of them voted for this outcome, either knowingly or foolishly, and they should realize that actions have consequences. Meanwhile, my investments are doing well, my health care (Medicare plus supplement) progam is stable, and my grown children are employed with health care benefits. I'm just a pointy-headed intellectual, limousine-liberal anyway. What do I know?
19
After this latest shambles, the question remains whether the Republicans can actually do anything that doesn't involve bending over for corporate lobbyists or cutting taxes on the wealthy. That most GOP activity in Washington is usually short-sighted and counterproductive apparently doesn't faze the party that believes its core mission is to run the country for the benefit of financial elites. Everybody else is either fodder to be duped, freeloaders or unwelcome foreign intruders. In the well worn phrase, we can do better. Much better.
13
It would have been hilarious if Paul Ryan was explaining the problems with insurance pools if he was explaining it for entertainment on the Comedy Central Network rather than Fox News (I don’t watch Fox News but I’m sure that he had a one minute segment of his presentation shown on that Network and the audience gave him a standing ovation.). Unfortunately this is another example of how Corporate America has purchased more than 50% of the three branches of Government
Most of the leaders in Corporate America are sociopaths or psychopaths who would rather throw xx,xxx,xxxx people under the bus rather than one of their own, the Healthcare Industry. A single payer system controlled by that humongous awful disastrous Government is the only sensible solution.
If we had an opt out on Social Security, what percentage would have taken it and not saved anything for retirement?
Most of the leaders in Corporate America are sociopaths or psychopaths who would rather throw xx,xxx,xxxx people under the bus rather than one of their own, the Healthcare Industry. A single payer system controlled by that humongous awful disastrous Government is the only sensible solution.
If we had an opt out on Social Security, what percentage would have taken it and not saved anything for retirement?
16
As I recall, the Senate Committee version of the ACA did everything it could to pacify moderate Republicans only to have the door slammed in the committee's face by McConnell for purely partisan reasons. proved to be great politics and
Opposing the ACA proved to be great politics but disaster for lower income people.
Opposing the ACA proved to be great politics but disaster for lower income people.
5
The GOP has always been the party for the wealthy and to achieve and maintain power they have been relying on lies and subtle racism spread by FOX and talk radio to confuse and persuade voters, especially older, white, poorly educated voters. The GOP well understands the power of repetition when lying. Until recently the mainstream media tolerated this tactic through its reliance on false equivalency to avoid being accused by the right that the media was choosing sides. Finally, the mainstream media is beginning to realize that the threat to our democracy posed by Trump and the GOP and is pushing back against the GOP's lies and bigotry. We can only hope it is not too late to preserve our democracy.
3
Offering your constituents "freedom" in lieu of access to government funded healthcare facilities and personnel has been remarkably successful for the GOP. I would imagine, the strategists in the offices of those representatives up for reelection in 2018 are starting to realize that they've run this strategy out. Viewing the televised town hall held by Chris Hayes and Bernie Sanders and aired on MSNBC, led me to believe that we might be at a tipping point. Even though Mr Sanders held a town hall in a neighboring community with probably the same folks and probably covering very similar issues, the community voted overwhelmingly for Trump. Why might we be at a tipping point now? Breaking through preconceived notions requires getting someone to stop and think about what they know and then presenting them with information. I believe that the concern folks are now feeling in the face of the bad press 'Tryancare' is getting will get them to stop and think what the 'freedom' they are being offered really amounts to.
2
Great piece by David L.
It can't be said enough: the ACA was a bipartisan, right-of-center construction of what earlier was the right-wing plan.
It can't be said enough: the ACA was a bipartisan, right-of-center construction of what earlier was the right-wing plan.
If there is any one consistent thing about Republicans it is their hypocrisy. However it is amazing how they can get voters to consistently send them back to elected office against their own self interest. This is why Trump loves his "poorly educated" .
2
a large part of the problem, as i see it, is that too many americans believe their country has nothing to learn from any other. despite spending way way more per capita, having few people covered, ranking very low in both infant mortality and life expectancy, lots of 'folks' are convinced the american system is superior to all others. facts, per usual, often go to die in the usa.
and did before trump.
and did before trump.
8
"Lying can be an effective political tactic."
I think Obama was all over that little gem.
I think Obama was all over that little gem.
3
I think there is a need to understand how Republicans think and then all of this will be clear. Their belief is this: A family of four is struggling making ends meet. Parents work two jobs each, the kids have jobs and still the bills are larger than the income. A rich relative (Uncle Sam) says, "Let me help get you out of the ditch by helping pay for your health care bills." The Republican response is "Sell one of the kids." After all he or she is an asset.
They simply do not believe that anyone needs a hand up and that anyone asking for a hand up is "working the system." They believe this when studies have shown that 93 percent of fraud committed in the welfare system is committed by provides, not beneficiaries. Republicans....the bottom line always matters except when it comes to war.
They simply do not believe that anyone needs a hand up and that anyone asking for a hand up is "working the system." They believe this when studies have shown that 93 percent of fraud committed in the welfare system is committed by provides, not beneficiaries. Republicans....the bottom line always matters except when it comes to war.
3
President Obama made several major mistakes in the launching of the PPACA, the biggest being his refusal to use his bully pulpit and exceptional oratorical skills to "sell" the program - to "make the case" directly to the American people. In so doing, he permitted the GOTP nihilists to completely dominate the airwaves, and to this day, most people still do not understand that this was not in any way a "government takeover," or "socialist" form of healthcare. The President also wasted nearly a year chasing the duplicitous former Senator Olympia Snow for her vote - in the end, she sold the administration and her own constituents down the river anyway. The genesis of the PPACA is a Heritage Foundation platform, and RomneyCare - hardly "liberal" bastions. Let us also not forget that the GOTP set out to obstruct every single policy initiative set forth by President Obama - with no concern for the welfare of the American people. They have always been about permanent power for white Christian men, and wealth - if the nation suffered, that was and still is merely collateral damage to them. 3/14, 9:39 AM
2
My health insurance premiums have increased 200% (tripled) and my deductibles have increased by 250% due to Obamacare. Additionally, my health care choices have been reduced. Other that that, Mr. Leonhard, its a great bill!
Speaking of infamous memos, why does no one remind people of the infamous memo Bill Kristol wrote to his fellow Republicans urging them to deny Clinton any health care bill because Clinton failing to get a bill passed would help Republicans win the midterms? Republicans did not vote down Clinton's bill because they thought our system did not need reform. In fact until Kristol's memo they agreed our system badly needed reform and were promising to offer up their own bill. They did not do it because they hated Clinton's proposals. They did it solely for partisan gain. This willingness of Republicans to put political power over the good of the American people started long before Obama.
4
What makes David Leonhardt thinks that the Republican party is facing any kind of dilemma? Taking benefits away from the poor in order to finance enormous tax cuts for the very rich is the very essence of the Republican Platform, and has been since at least 1980.
6
It was never about bipartisanship. It was never about socialism. It was always about keeping money in the hands of their big donors. The question is did anyone really believe in the original fig leaf of the supply side economics? This Republican play book is over thirty years old. In this last election they have simply sold their souls to someone who blew the dog whistles of louder. It worked because of rising fear and a social injustice backlash. The problem now is how to move the Democrats away from their own big donors who only support them largely because of a leaning toward a more liberal social agenda but maintain a feeling about tax policy that has moved too far to the right due to 90's era New Democratic party centrism.
2
Right on the money, in every way. As a liberal, I'm for single payor, and was disappointed but understood when Obamacare tacked to the right, embracing the capitalism and consequent complications of a powerful insurance industry. Republicans had their chance to help pass the much-needed fixes to the law, instead chose to follow a morally bankrupt ideological path of mindless opposition leading to ... well, here we are. An estimated 24 million off the rolls, and the extra bonus of tax breaks for the wealthy and gutting Medicaid for the elderly, disabled, and poor. With this plan, the GOP is no longer even bothering to disguise its disdain for the American people, just a bunch of gutless old pols on the make.
Mitch McConnell is the single biggest obstacle to progress in the legislature. Dump McConnell and send him back to Kentucky, and the system will begin functioning again.
I do have some issues with the ACA, but it's a real shame that Republicans and Democrats cannot work together to come up with some compromises that could fix the problems. (Even President Obama and Dr. Ezekiel Emanuel were on the Today show last year admitting there were problems.) All you hear on the news coverage of this current debate are sound bites, broad platitudes and missiles thrown by each side at the other. My Republican friends screech against anything attached to Obama. My Democrat friends defend anything attached to Obama without even acknowledging that there could be some problems that need to be fixed. Too much politicking, not enough policymaking.
1
"Republicans shifted even farther right..."
Please, should be further, not farther.
Otherwise I appreciate this article.
Please, should be further, not farther.
Otherwise I appreciate this article.
1
Both sides exaggerate. This is not a surprise. I live in MD and was able to purchase health ins at a reasonable cost. (I have a pre-existing condition that is very expensive to manage.) I always ask for specifics when some people talk about outrageous deductibles or that they only had one or 2 companies to chose from. (In Maryland BCBS is one company with many many different options so just saying we have one or two companies does not mean you have one or two PLANS to choose from). Usually I find that people did not research when choosing the correct plan for them and their family or they are referring to somebody who lives in a state that did not accept the fed gov assistance. Congress needs to work together and come up with a better plan over all. It will not be perfect and there will always be some people that do not like it no matter what.
Oh... I worked for one of the largest corps in the world. They increased our rates and introduced tier options (large deductible low premium to high premium low deductible). This was before Pres Obama took office. The CEO warned us as early as 2003 that health ins would be addressed in upcoming elections. He said it was going to become too costly for consumers and that too many did not have coverage.
Oh... I worked for one of the largest corps in the world. They increased our rates and introduced tier options (large deductible low premium to high premium low deductible). This was before Pres Obama took office. The CEO warned us as early as 2003 that health ins would be addressed in upcoming elections. He said it was going to become too costly for consumers and that too many did not have coverage.
2
For six long years all we heard was repeal and replace. In that amount of time you would have thought that the plan the republicans finally came up with would be great. Unfortunately they didnt start working on it until February and it shows. The mandate was necessary to counter balance the coverage that the poor and old gained so the insurance companies would go along. They gladly took the premiums but I guess their bottom line wasnt as large as they dreamed so they started dropping plans in the rural areas. Plus the CEO's had to pay taxes on their outrageous salaries and we know we shouldnt tax the rich. So now we have a choice. If you are wealthy or super poor you can get insurance. Otherwise your choice is to die or go to the emergency room every time something is wrong with you. It was soooo easy to just say NO to everything when Obama was in the White House. I think they might finally realize governing is more than being in the opposition. We have to hope that the voters actually start paying attention to who is causing the problems with health care and vote in all coming elections to purge the lifelong republican haters from running (ruining) our country. But that is a lot to hope for in a country that no longer reads more than 140 characters at a time.
3
According to the IRS 6.5 million taxpayers choose paying the penalty vs. buying healthcare insurance. Another 12.7 million are granted a waiver on said penalty. So that is almost 20 million people that choose not to participate in the healthcare insurance risk pool, and that is the basic flaw in Obamacare,
The penalty is too low, the cost is too high. It has failed. You will always have a fairly large group that will drag the system down. Obamacare was designed to be a closed loop system. It is not, and it never will be.
It is hard for Liberals to understand, but there are people who choose risk and pay as you go with healthcare. And apparently there are a lot of them.
The penalty is too low, the cost is too high. It has failed. You will always have a fairly large group that will drag the system down. Obamacare was designed to be a closed loop system. It is not, and it never will be.
It is hard for Liberals to understand, but there are people who choose risk and pay as you go with healthcare. And apparently there are a lot of them.
1
The original lie from Republicans is that they care for people . The fact is that they are politically motivated and care most of all about their bottom line. It is obvious in their actions and squirming when caught out.
1
And so the proverbial chickens come home to roost!
Democracy has no means to protect itself from liars, especially if they own megaphones which drown out the truth.
Democracy has no means to protect itself from liars, especially if they own megaphones which drown out the truth.
1
Thank you for your candid account of the lie Republicans have repeatedly utilized in discussing the Affordable Care Act. However, I think there is a component of the Republican opposition to President Obama's efforts to enact health care legislation- racism.
From the day of his swearing in to his last day in office, Republicans did everything to frustrate or deny any action undertaken by President Obama, the first African American President of the United States. Republicans in ways small and large tried to delegitimize President Obama from Republican Joe Wilson screaming ," You lie" ( twice ) during a State of the Union address, without rebuke by Republican leadership, to trying to stymy his effort to save the economy or provide health care coverage. Mitch McConnell, a good old boy from Kentucky, vowed from day one of President Obama's administration to make Obama a one-term president, regardless of his policies.
In sum, the Republican party tried to undercut the President for 8 years, and are still actively trying to eliminate any trace of his presidency, for what I believe was,in part, based on racism.
From the day of his swearing in to his last day in office, Republicans did everything to frustrate or deny any action undertaken by President Obama, the first African American President of the United States. Republicans in ways small and large tried to delegitimize President Obama from Republican Joe Wilson screaming ," You lie" ( twice ) during a State of the Union address, without rebuke by Republican leadership, to trying to stymy his effort to save the economy or provide health care coverage. Mitch McConnell, a good old boy from Kentucky, vowed from day one of President Obama's administration to make Obama a one-term president, regardless of his policies.
In sum, the Republican party tried to undercut the President for 8 years, and are still actively trying to eliminate any trace of his presidency, for what I believe was,in part, based on racism.
2
Nice job, David, thank you. We need much more of this kind of thoughtful, savvy and well researched journalistic work.
Although this comment is somewhat out of place in the context of this article I want to say that I have often been disheartened to hear so many right wing commentators supporting the idea that a single payer health care plan means that you are sharing in the cost of other folks misfortune, aging and bad behavior. Of course they never mention that the reverse is also true. The target of their vitriol are the people who have little money and need help. In Canada we talk about our health care system a lot and how to make it better but nobody wants to trash it and I have never heard anyone say that they thought a homeless, aging or injured citizen should not have the same health care as they have and I have never seen anyone lose their home to medical bills. As we say here, what goes around, comes around.
Although this comment is somewhat out of place in the context of this article I want to say that I have often been disheartened to hear so many right wing commentators supporting the idea that a single payer health care plan means that you are sharing in the cost of other folks misfortune, aging and bad behavior. Of course they never mention that the reverse is also true. The target of their vitriol are the people who have little money and need help. In Canada we talk about our health care system a lot and how to make it better but nobody wants to trash it and I have never heard anyone say that they thought a homeless, aging or injured citizen should not have the same health care as they have and I have never seen anyone lose their home to medical bills. As we say here, what goes around, comes around.
2
Mr. Leonhardt has done a great job telling an accurate story of how Obamacare/ACA really came to be and what role each party had. I agree completely but I draw the opposite conclusion. Leonhardt seems to believe that the Republicans' increase radicalism, their inability to accept a truly bipartisan plan, and their uncompromising opposition have put them in a corner where all choices have bad results for them. I disagree. I think the success of the "original lie' about Obamacare lay in the fact that, as Leonhardt acknowledges in his first line, even some Democrats believed it. It isn't just that the public and the beneficiaries of the ACA have been late to come to its defense. Democrats allowed themselves to be bullied and silenced, and they ran from Obamacare instead of running on it during Obama's term. I know that taking away a benefit often has more electoral benefit than providing one, but I'm not yet convinced that voters who did not reward Democrats for ACA will now punish Republicans for taking it away. Republicans consistently "win" the rhetorical contest: maybe it's dishonesty, maybe it's voter ignorance, maybe it's the money and muscle behind the message, maybe it's Democratic weakness -- caught between corporate donors and a populist base. Whatever the reason, Republicans have been winning these arguments (ACA is a great example), and it's going to take a big, big push to change that.
> "The AARP doesn’t like the bill..."
You might explain why the AARP doesn't like the bill. I'll explain since you did not.
The health care ratio of costs of young to elderly is 1:6 but instead Congress mandated the ratio be 1:3 meaning that the young were paying about 75% higher premiums than they would otherwise and before they mandated the ACA. The AARP and Congress want the young to subsidize the high health care costs from chronic diseases of the elderly caused by smoking and obesity with much of that obesity coming from drinking sugar-sweetened beverages such as Coke.
The new law mandates a far more equitable and fair 1:5 ratio so the young have lower cost premiums.
50 years ago there were health warning messages on cigarettes but boomers and others chose to ignore them. Why exactly should the young pay for older people who chose to ignore the warnings? Perhaps the AARP could answer that question. Why should the young have to pay for the junk food habits of the elderly including drinking Cokes (drinking a daily 20oz vending machine bottle of Coke is like consuming over 50 lbs of sugar per year).
The under 30 crowd today drink water and coffee, I rarely see the Cokes and other SSBs.
The young need to build their life and they shouldn't have to pay for the unhealthy lifestyle choices of the elderly. The young people I have spoken with agree. Perhaps Mr. Leonhardt would interview young people on his own and ask them and report about it.
You might explain why the AARP doesn't like the bill. I'll explain since you did not.
The health care ratio of costs of young to elderly is 1:6 but instead Congress mandated the ratio be 1:3 meaning that the young were paying about 75% higher premiums than they would otherwise and before they mandated the ACA. The AARP and Congress want the young to subsidize the high health care costs from chronic diseases of the elderly caused by smoking and obesity with much of that obesity coming from drinking sugar-sweetened beverages such as Coke.
The new law mandates a far more equitable and fair 1:5 ratio so the young have lower cost premiums.
50 years ago there were health warning messages on cigarettes but boomers and others chose to ignore them. Why exactly should the young pay for older people who chose to ignore the warnings? Perhaps the AARP could answer that question. Why should the young have to pay for the junk food habits of the elderly including drinking Cokes (drinking a daily 20oz vending machine bottle of Coke is like consuming over 50 lbs of sugar per year).
The under 30 crowd today drink water and coffee, I rarely see the Cokes and other SSBs.
The young need to build their life and they shouldn't have to pay for the unhealthy lifestyle choices of the elderly. The young people I have spoken with agree. Perhaps Mr. Leonhardt would interview young people on his own and ask them and report about it.
1
There's only so far their lie can go. They can lie about the CBO report now, but when 14M people actually lose insurance next year, they won't be able to convince those people that they actually have insurance.
1
Paul Ryan, author of this dreadful piece of legislation, does not have a lock on his congressional district. (Obama carried the district in 2012.) Putting Ryan into the workforce again should be the Democrats first order of business in 2018.
3
The way to fix Obamacare is to add a public option. Too bad that was allowed to disappear from the original version.
1
I live out here. Most people will TELL you "Death Panels" are part of the ACA.
I've quoted the actual wording of the (eventually deleted) provision that merely authorized Medicare to reimburse doctors for time spend discussing end-of-life decisions. Goes right past their ears. It has to go down as one of the most successful lies in political history.
How do you induce people to vote for their own best interests, when they prefer to believe the worst news?
I've quoted the actual wording of the (eventually deleted) provision that merely authorized Medicare to reimburse doctors for time spend discussing end-of-life decisions. Goes right past their ears. It has to go down as one of the most successful lies in political history.
How do you induce people to vote for their own best interests, when they prefer to believe the worst news?
Never underestimate how sneaky, cunning, devious, heartless, indifferent to humankind (except rich folks) Republican politicians are. McConnell, Ryan, and GOP House and Senate committee leaders are already scheming behind the scenes. They will make sure most of the disastrous terms of the American Health Care Act won't go into effect UNTIL AFTER the 2018 Mid Term elections. They want to keep their House seats and continue gutting the well-being of millions of Americans. Once re-elected by the ignorant masses who voted them in, then they will pass RyanCare.
3
Thank you for the insight in tis column. Since the ACA passed, I have been baffled by Republican opposition to what was essentially a Republican model. I could only draw two conclusions: 1) for purely political reasons, the Republicans would oppose anything our first mixed-race president proposed in order to play to their base, or 2) the Republicans really are hard-hearted and did not want to extend healthcare to the less fortunate. Both possibilities raised profound questions about the true nature of the Republican party. I did not want to believe that one of our major parties could act this way. Seeing the outlines of Ryan / Trumpcare and the CBO report, I now have to believe that this is a group of hideously cruel people who hide behind false piety and patriotism. If this monstrosity passes and goes into effect, Ryan, Price, McConnell and the other Republicans who push it through had better thoroughly enjoy life while on earth because when they reach the pearly gates, the final judgment will be harsher than the pain they are meting out on their fellow citizens.
1
The only way we will get universal healthcare is if all of us keep the pressure up. Just keep it up. It is the only way.
1
As an American who has moved to Australia, I find myself doing a lot of explaining to people about what living in America is like. I work with people who habitually complain about the wage they earn. As a social worker, I can say that people in this field here in Australia are much better paid than they are in the USA. When I tell them what staff with their education and experience (Bachelor Level) are paid in America, they say "I wouldn't work for that, I'd bartend". And are shocked when I say, "But, how will you get health insurance?' Then as people who have grown up with cradle to grave coverage they are shocked. It's not humane they say. And I have to say, I agree. I grew up in the States with that fear of "socialized medicine" and waiting for medical care. And the expense. Well, I'm taxed less than I paid for insurance for my family.
Doctors here are not paid overly inflated rates. Without medicare, a visit to the GP is still affordable. The US would do well to figure out a way to cover people universally. In the end, it's the consumers that pay the bill without some type of universal coverage. People are kidding themselves if they think the burden of health care for the 24 million that will lose coverage won't fall on the taxpayer--it will.
Doctors here are not paid overly inflated rates. Without medicare, a visit to the GP is still affordable. The US would do well to figure out a way to cover people universally. In the end, it's the consumers that pay the bill without some type of universal coverage. People are kidding themselves if they think the burden of health care for the 24 million that will lose coverage won't fall on the taxpayer--it will.
Thank you for this.
Republicans Ryan, McConnell, and more seem to believe if they ignore this, it won't be a problem.
They're not worthy of the time of day for what they have done and are doing.
Please let their childish grip on the levers of government end.
Republicans Ryan, McConnell, and more seem to believe if they ignore this, it won't be a problem.
They're not worthy of the time of day for what they have done and are doing.
Please let their childish grip on the levers of government end.
2
The problem was that Obama reneged on his campaign pledge to favor universal single payer health insurance (i.e. Medicare-type health insurance for all). He caved in. Had he pushed for this, today no candidate would be able to repeal such a system, too many Americans would oppose any repeal. Instead he settled for a plan that Republicans could easily take aim at. Obama was looking for Congressional support when he should have been going after popular support.
Obama tried to compromise and Lucy yanked away the football.
The Republicans are in deep trouble with their bill. They are now attacking their own bill from right to save face.
Meantime, they've picked the wrong fight. The people who elected Trump expect Trump and the Republicans to create jobs for high school graduates that support a middle class lifestyle. That is what Trump promised. They did not vote for him to destroy healthcare.
Trump's Presidency is in danger of burning out in the first hundred days.
The Republicans are in deep trouble with their bill. They are now attacking their own bill from right to save face.
Meantime, they've picked the wrong fight. The people who elected Trump expect Trump and the Republicans to create jobs for high school graduates that support a middle class lifestyle. That is what Trump promised. They did not vote for him to destroy healthcare.
Trump's Presidency is in danger of burning out in the first hundred days.
3
The Republicans have had their hands around the neck of the ACA from the very beginning and now they are complaining it cannot be sustained, it's dying...what a joke. But I have had it with trying to explain to people (including one of my own children) how destructive the R's plan will be for the poor, the elderly, and the sick. How their plan is really a tax cut for the wealth and not a healthcare plan at all, but now I think it is time for me to let it go, I can no longer fight for the misinformed and the ignorant. So my fellow American's it is time you get the plan you voted for. It is time for the R's to pass their plan without any Democratic support and then we will just have to see how that works out for them. And a special message to my congressman, Paul Ryan, remember everything you pass can and most likely will be reversed and your time as speaker will likely be remembered as a disaster.
2
The dog finally caught up with the car and now he doesn't know what to do with it. The modern Conservative movement has become nothing short of cruel. And while TrumpRyan Anti-Healthcare plan is cruel, their Tea Party colleagues want to take cruelty to their fellow Americans to new heights.
The party of family values, Jesus and morality has been exposed as a fraud of catastrophic proportions.
The party of family values, Jesus and morality has been exposed as a fraud of catastrophic proportions.
1
The New Yorker writer and author Jane Mayer lays out in her book, "Dark Money," the real reasons why Republicans refused to support the ACA. At first, President Obama received numerous suggestions for a health care bill from Republicans. But then, right-wing billionaires David and Charles Koch sent a memo to all congressional Republicans threatening that if any of them supported Obama's health care plan, the Kochs would oppose them and find primary opponents to run against them. All cooperation from Republicans stopped.
The Kochs spent over a quarter of a billion dollars trashing the ACA, and probably far more in funds that were not traceable to them. The Kochs still oppose any form of government involvement in health care, and that's why their lackeys in the congress have essentially put the government on a path to eliminating any support.
The billionaires own the Republican Party. And those far-right billionaires don't care in the least whether regular Americans live or die.
The Kochs spent over a quarter of a billion dollars trashing the ACA, and probably far more in funds that were not traceable to them. The Kochs still oppose any form of government involvement in health care, and that's why their lackeys in the congress have essentially put the government on a path to eliminating any support.
The billionaires own the Republican Party. And those far-right billionaires don't care in the least whether regular Americans live or die.
5
Both the right AND the left lie to themselves. I read many people here that defend Obamacare who clearly do not use it. It's terrible here in Missouri, where there is a vast uninsured "dead zone" and only ONE company in the marketplace to "choose" from (and its network does not include the state's best hospitals). It's somewhat better on the other side of the river in Illinois, which expanded its Medicaid..... but not by much. Their options have gone down from six to three, I understand, and their premiums, co-pays, and especially, deductibles, have also sharply risen. For every time that these important issues are raised in this paper, the higher "number of insured people" is addressed about 20 or 30 times, from my estimate. (Whether their medical care has significantly improved given the enormous deductibles is rarely considered.) If liberals are moved by this article and see Obamacare as the free-market, republicanesque plan that it is, they might stop lying to themselves and others that Obamacare is wonderful. Obama, a great guy, missed another opportunity here by playing it safe. We need a single-payer system or to, at least, expand Medicare down to 55.
- 400 richest families each get a tax cut of $7 million/year
- “CBO scores no to be believed, just math & science”
- millions of citizens lose insurance & care
- Americans will die from curable illness
- all pay more for less coverage
- Medicare is insolvent sooner
- Conservatives complain plan is too generous to their constituents
The original Russian meddling: Ayn Rand Ideology
- wealthy & powerful are the oppressed minority
- enough is never enough for me and mine
1976: Social Worker enrolls Ayn Rand in Social Security & Medicare
- “CBO scores no to be believed, just math & science”
- millions of citizens lose insurance & care
- Americans will die from curable illness
- all pay more for less coverage
- Medicare is insolvent sooner
- Conservatives complain plan is too generous to their constituents
The original Russian meddling: Ayn Rand Ideology
- wealthy & powerful are the oppressed minority
- enough is never enough for me and mine
1976: Social Worker enrolls Ayn Rand in Social Security & Medicare
1
It is so childish and obvious to hear the GOP folks spewing the same party line - over and over again. The ACA is imploding, it's a disaster, it's a failure. Sad that health care in this great country is in the hands of politicians, now the Republicans who cannot solve the puzzle but can only offer something worse and try to cram it down our throats - just as they accused the Dems of doing in 2010. Health care is a fundamental need and yet the US health care plan is in the hands of people who can only try to implement a plan worse than the ACA by using the most extreme and completely misleading political rhetoric. A badly flawed political response to an empty political promise. This issue needs patients and expertise, two things NOT present!
They don't expect this to pass. What it is doing is causing turmoil that will cause even more insurance companies to leave the market insuring that people suffer more next year under the ACA. Their hope is to make Obamacare look so bad that people will take anything in 2019 just after the midterms. The democrats need to be messaging loudly and working with insurers to make sure the markets survive through next year. The republicans only care about winning and could care less who they hurt.
1
Paul Ryan is the quintessential mountebank -- a medical specialist, distinguishing him from a mere charlatan.
Ah, but how can you compare the endless hoarding by the rich to the well-being of a society? It is not even discussable in the train-wreck called 21st century America.
2
The sad truth is that the GOP is more interested in making Obama and the democrats look bad rather than actual solutions. They had chance after chance to improve on the ACA, and really still do, but Ryan, McConnell, Trump, and their devoted party followers are not interested. Every Trump utterance is just an insult and bombastic, and Ryan isn't really interested in the other half of our population
These leaders are not elected to represent half or special interests but sure do act like it. It's dangerous and sad
These leaders are not elected to represent half or special interests but sure do act like it. It's dangerous and sad
1
And please don't miss the new Broadway Show about the life of Donald Trump, "The lying King".
They are looking for a better health care bill in all the wrong places. The GOP reminds me of the person who tears up the house trying to find their car keys - when all along the missing keys were in their pocket. Sometimes the best solution is the one that is just too easy to overlook.
single. payer. health. care.
Medicare. for. ALL.
single. payer. health. care.
Medicare. for. ALL.
1
It seems likely that Trumpcare is DOA. What comes next is the Republicans step back and let ACA die through the Don's Executive orders undercutting it and legislative inaction re correcting its flaws. That way the GOP can have their cake and eat it too. Our slide into Bannon's dystopia continues.
1
Wouldn't the GOP gather support if they just did the right thing for "All". There will be a backlash against the party unless they find it in their hearts to put the people of this great country ahead of "Big Business".
People will be tired of "eating cake" and rise like never seen before. The yeast is just below the surface.
Oh where are the likes of Ike?
People will be tired of "eating cake" and rise like never seen before. The yeast is just below the surface.
Oh where are the likes of Ike?
2
As the old saying goes, when you try to please everyone, you end up pleasing no one. Just looking at the favorability numbers on Medicare should be all it takes to convince legislators that a single payer, everybody in plan from birth to death like virtually every civilized modern country already has in place is the only sensible option. Another comment stated that President Obama should have "crammed a good plan down their throats." I absolutely agree. He probably would have ended up with more universal support from his own party without all the garbage concessions he made trying to please the Republicans whose only goal was to defeat anything he was for at all costs. That is what my mother used to call "cutting off your nose to spite your face." Get with it guys and finally so the right thing...Universal Coverage!
1
I have an idea. Doctors REFUSE to accept any congressional health insurance until Congress passes a great health insurance plan. Cash only, senator!
1
I find it difficult to believe that a political party loaded with White Catholics & Evangelicals who voted for Trump, is so scrooge-like that they would deny millions of Americans affordable health care. To make their actions even more deplorable, they are planning to give the wealthy a large tax cut which would lessen revenue for social benefits. I guess that is what to accept when the the congress is loaded with millionaires and billionaires. The oligarchs rule.
216
Here's my confession: I really don't care what happens to Trump voters who would lose their health insurance under the GOP plan -- the easily deluded and ill-informed individuals who excoriated "Obamacare" but were more or less okay with the Affordable Care Act... the people who bought into the Great Prevaricator's lies about "covering everybody" with a plan that was comprehensive, inexpensive and, you know, "really great -- the best and most wonderful plan ever."
Many of these same voters had no insurance prior to the ACA, and many were able for the first time to access reasonable health care for serious illnesses and chronic conditions. To them, I say, good luck, if this bill or a variation of it somehow survives. You voted for this mess, and you own it.
I feel badly about my lack of compassion for them (or maybe not so much).
Many of these same voters had no insurance prior to the ACA, and many were able for the first time to access reasonable health care for serious illnesses and chronic conditions. To them, I say, good luck, if this bill or a variation of it somehow survives. You voted for this mess, and you own it.
I feel badly about my lack of compassion for them (or maybe not so much).
2
Great, again!
One hopes for a 2018 congressional upheaval, and early impeachment of Trump on foreign corrupt practices violations in Azerbaijan, and conflict of interest/emoluments charges. Removal of the electoral college, returning to one man-one vote is probably too much to hope for.
One hopes for a 2018 congressional upheaval, and early impeachment of Trump on foreign corrupt practices violations in Azerbaijan, and conflict of interest/emoluments charges. Removal of the electoral college, returning to one man-one vote is probably too much to hope for.
I can't help but wonder how the Russian mafia and Putin will benefit from the new law changes. Trump seems in their pocket. Are we supposed to go to war against China for Putins benefit as well?
1
How about this for a Trumpian Gordian knot? What if those on Medicare and employee-sponsored health insurance were told that they would be taken care of in terms of health care, but the trade-off would be that those on the ACA and Medicaid would largely suffer and die as a result. What do you think people would do? An interesting question, isn't it? That is, assuming people really believed it.
1
The original lie stuck, and the current Trumpp lie ("Obamacare is collapsing") might be kept going, too.
2
Let's face it: neither the Republican Party's bigwigs (e.g. The Koch Brothers) nor its leaders (Paul Ryan and Mitch McConnell) believe that government has a role in health insurance. That's the theology. Additionally, Republicans don't want to pay taxes, particularly if their tax dollars are benefitting less fortunate members of society.
If you cut through the fog that's coming from the Republicans' PR machine, that's what's behind the gutting of Obamacare. All the other arguments are just smoke intended to get the public to act against its interests once again.
If you cut through the fog that's coming from the Republicans' PR machine, that's what's behind the gutting of Obamacare. All the other arguments are just smoke intended to get the public to act against its interests once again.
2
Lying constantly and creating alternative facts is the Republican's norm. It will only get worse. The wealthy, the banks and the corporations will own and control everything - this is the soon-to-arrive Republican Paradise. Enjoy it America, you enabled it. Now look into your children's eyes and explain to them what you have done.
1
Liberals need to grapple with the truth that conservatives don’t want anyone to have health care. That statement is not too strong. They don’t want your paws on their tax dollars. Caring for you is an assault on their freedom. Don’t forget: we’re dealing with ideologues who do not believe clean water is a right. Although it’s difficult to admit that people can be wicked, we need to admit the selfishness and wickedness that underpins such positions—and then formulate a plan, rooted in clarity, to defeat them politically. (A very Clinton-free plan.) They will never be won over. They can only be kept out of power.
Rest assured the Republican party will continue making up lies, blaming others and taking no responsibility for their mistakes.
Depend on it.
Depend on it.
1
From the very beginning, there were so many lies, all designed to scare people and suppress enrollment in the ACA. Going to the doctor would become as miserable as a trip to the DMV. Patient care would be rationed, with death panels as the final arbiter. Republicans' real objection was and remains that the ACA taxes the rich in order to subsidize health insurance for the poor. More than anything else, that transfer of wealth is anathema to Republicans. As a result, they have concocted a plan that does away with the ACA's taxes. However, without those $100s billions in revenue, there is no way to match the coverage of the ACA. Indeed, the Republicans aren't even trying to match the coverage. With their proposed legislation, Republicans have at last done away with the notion that they care about average Americans. Their biggliest lie of all has finally been exposed.
1
That is "patience," not patients - no pun intended!!
Hyper-partisan politics fails us again. The GOP is transparently putting their political party over the interests before the country's wellbeing. Not only are the members of the GOP willing to support the Orange Menace but now they'll do his bidding in deconstructing our entire healthcare industry.
It is time to end this madness; the GOP must be forced to end as a political party, they have nothing left to offer but more tax cuts that will turn the country into a Dickinsonian nightmare of a privileged few and masses of poor, angry people.
It is time to end this madness; the GOP must be forced to end as a political party, they have nothing left to offer but more tax cuts that will turn the country into a Dickinsonian nightmare of a privileged few and masses of poor, angry people.
2
"Believing your own alternative facts, however, is usually not so smart."
Alternative facts, false claims of wire surveillance, claims your microwave can be used as a camera (just so odd), excessive costs for weekends trips to Florida, more costs to cover Trump Tower and the trips of all the Trump kids, questionable ties to Russia, and the list goes on.
Makes you miss the other president ... anyone of them!
Alternative facts, false claims of wire surveillance, claims your microwave can be used as a camera (just so odd), excessive costs for weekends trips to Florida, more costs to cover Trump Tower and the trips of all the Trump kids, questionable ties to Russia, and the list goes on.
Makes you miss the other president ... anyone of them!
1
The "death of capitalism" regarding health care might be the best idea for 99% of us. If it works for the rest of the developed world, why can't it work here? Single Payer for all!
1
Trumpcare is off to a rocky start.
I look around at other countries that have universal coverage and really wonder why so many in the US are opposed to it. Have have never been given a good answer to that.
I look around at other countries that have universal coverage and really wonder why so many in the US are opposed to it. Have have never been given a good answer to that.
2
Pathetically, you know when the GOP leadership will care about healthcare for all? When it's too late.
When the next airborne Ebola hits our shores and it is spread by the "Great Unwashed" who didn't go to the doctor but to the ER as a last resort, we will all pay.
Beyond being humane and decent, healthcare for all is a matter of national security.
Until then, GOPers in the House and Senate and old #45 better hope no one coughs on them or their families.
When the next airborne Ebola hits our shores and it is spread by the "Great Unwashed" who didn't go to the doctor but to the ER as a last resort, we will all pay.
Beyond being humane and decent, healthcare for all is a matter of national security.
Until then, GOPers in the House and Senate and old #45 better hope no one coughs on them or their families.
2
How is it that leaders of the "Party of Life" can argue against universal health care and coverage? In what worldview does the Creator who they claim rules their actions in favor of life tell them that they should not provide coverage and health care to those too poor to afford it? Aren't they ashamed? Don't their consciences bother them? Is this really why they get up every morning and go to their offices to do God's work? Seems we are living in an age where irony and hypocrisy are dead.
We need a new Charles Dickens who could draw us a picture of the Cratchitts and Tiny Tim living in NYC or any small town in America. Maybe that would draw a speck of compassion for those they leave behind. But don't look for such a book from a Christian writer--they seem more concerned about the mythical idle poor, lounging in front of huge flat screen TV's than about sickly children who never get the chance to grow up. Better to give huge tax breaks to the deserving idle rich so they can build a third, fourth or fifth home--that will goose the employment figures!
We need a new Charles Dickens who could draw us a picture of the Cratchitts and Tiny Tim living in NYC or any small town in America. Maybe that would draw a speck of compassion for those they leave behind. But don't look for such a book from a Christian writer--they seem more concerned about the mythical idle poor, lounging in front of huge flat screen TV's than about sickly children who never get the chance to grow up. Better to give huge tax breaks to the deserving idle rich so they can build a third, fourth or fifth home--that will goose the employment figures!
3
THE ORIGINAL LIE about Obamacare is not quite a lie. Rather a misnomer. Because the correct appellation would be Mitt Romney Care! A plan that worked very well when Romney was governor of Massachusetts. Obama held the honorable notion that borrowing the model of a then-moderate Republican would be appreciated. And establish the fact that Obama was interested in the best interests of US citizens. Also, he showed deference to the GOP. An honorable gesture that was never returned. The opprobrium dumped on Obama for 8 years was a national disgrace, being carried forward by Trump and his band of thugs. Rather than Trumpcare that is a giveaway to the 1% and ripoff of the 99% let's go back to Romneycare.
1
A few years before my Grandmother passed, she was staying with our family. She suffered from terrible Alzheimer's.
Anyway, one day we were drinking some iced tea and chatting, and suddenly she ask, "Where my tea?"
I pointed to her hand, which was holding her glass of tea. "It's right there in your hand, Grandma," I said with a smile.
She looked down and then said "That's not my hand."
The GOP is like my grandmother - totally blind to the fact that they are "fixing" something that wasn't broken. Should this odious bill pass into law, I fully expect a disaster, and I also expect we see plenty of Republicans claiming that they had nothing to do with it.
"Not my hand," they will say, even with their fingerprints all over it.
Anyway, one day we were drinking some iced tea and chatting, and suddenly she ask, "Where my tea?"
I pointed to her hand, which was holding her glass of tea. "It's right there in your hand, Grandma," I said with a smile.
She looked down and then said "That's not my hand."
The GOP is like my grandmother - totally blind to the fact that they are "fixing" something that wasn't broken. Should this odious bill pass into law, I fully expect a disaster, and I also expect we see plenty of Republicans claiming that they had nothing to do with it.
"Not my hand," they will say, even with their fingerprints all over it.
5
President Obama wasn't satisfied that the Affordable Care Act was "The Solution". He and many of us who supported ACA believed it was an imperative step that allowed American Citizens of all ages to gain access to affordable Healthcare. The plan has always been that the system would modify and improve the system. Trump & Ryan's Plan is a SHAM. Health Care is a human need. It needs to be affordable and accessible. Doctors and nurses working in Emergency Rooms realize this, parents, communities, senior citizens and educators realize this. The majority of American Citizens realize this. 24 million people can't lose their healthcare. If they do... The Republicans can kiss the political power they now hold...goodbye. American Citizens don't respond well to dishonesty and manipulation. Trump and Ryan are dishonest and manipulative. There going to take from the poor and give to the rich...the very rich. That's their solution. Hmmm....The Swamp is Reeking.
5
The only obstacles to good health care for all in America are stupidity and greed. It's no secret that the best way to keep the cost and delivery of health care manageable is through government-sponsored single-payer systems common throughout the industrialized world, systems like Medicare that serves our senior citizens so well and has effectively reduced poverty in that population. Republicans and Democrats both know this so I guess we can eliminate stupidity as an obstacle. Greed is going to be more difficult to overcome.
3
They keep saying the ACA is imploding, all the while the President is imploding. A perfect projection from the master projectionist. "I know I am but what are YOU?"
3
Thanks for a cogent overview of a sad history.
This retired physician still, after five decades of practicing medicine and surgery in Africa, Vietnam, Antarctica, Atlanta, Seattle, .... etc., remain appalled at our addiction to a cruel, crippled health care system that abandons those unable to care for themselves.
I hope for our children's welfare that your closing statement is correct "Lying can be an effective political tactic. Believing your own alternative facts, however, is usually not so smart."
Please keep us all paying attention to this systemic cruelty.
This retired physician still, after five decades of practicing medicine and surgery in Africa, Vietnam, Antarctica, Atlanta, Seattle, .... etc., remain appalled at our addiction to a cruel, crippled health care system that abandons those unable to care for themselves.
I hope for our children's welfare that your closing statement is correct "Lying can be an effective political tactic. Believing your own alternative facts, however, is usually not so smart."
Please keep us all paying attention to this systemic cruelty.
6
I have often wondered how & why Democrats have let Republicans get away with this lie for so long. I remember the summer of 2009 with extended coverage, in this newspaper and others, of Republican resistance and Democratic compromise, over & over again. I remember the editorials and cartoons criticizing Obama for giving away his shirt as a *start* to the negotiations, and the Republicans moving the goal posts farther to the right every time he took a step in their direction. Then they unanimously refused to vote for it (while, as always, accusing the Democrats of "voting in lockstep"). And not only that, ever since then they have acted like this mess of an ACA, which they were instrumental in mangling into a grotesque version of its intended self, was passed in the dead of night with no negotiation, no compromise, no bipartisan input.... and everyone lets them get away with it!
Last summer I engaged in a fairly spirited debate about this in the comment threads of my local paper, with a conservative who bought into the "rammed it through" narrative. I provided links to contemporary articles describing the negotiations while they were going on. He looked at them, acknowledged the events that had taken place, and *still* insisted that the bill was pushed through Congress with no input from Republicans.
Now that narrative is so firmly entrenched that columns like this one can be safely dismissed as "fake news" by people whose memories have been wiped. Sad!
Last summer I engaged in a fairly spirited debate about this in the comment threads of my local paper, with a conservative who bought into the "rammed it through" narrative. I provided links to contemporary articles describing the negotiations while they were going on. He looked at them, acknowledged the events that had taken place, and *still* insisted that the bill was pushed through Congress with no input from Republicans.
Now that narrative is so firmly entrenched that columns like this one can be safely dismissed as "fake news" by people whose memories have been wiped. Sad!
5
Your account goes back in history as far as LBJ. But you forgot to mention that even Nixon proposed health care reform, and after Nixon there was a large democratic majority with Carter as president.
Why did Carter fail to pass his health care reform bill? Ted Kennedy wouldn't compromise. Because Ted Kennedy and his cohort would not settle for half a loaf, the American people got nothing until the ACA.
Why did Carter fail to pass his health care reform bill? Ted Kennedy wouldn't compromise. Because Ted Kennedy and his cohort would not settle for half a loaf, the American people got nothing until the ACA.
2
You, of course, parrot Chuck Schumer, in mentioning that groups like AARP and the AMA are against the Republican's Health care proposal. Both of these groups have become far left in their positions on practically everything, and that is why most physicians like me have abandoned the American Medical Association in the last 20 years. At this point, they represent a fringe group of doctors. Obamacare was neither affordable nor was it coverage for most patients. In addition, my own personal premiums skyrocketed as did my deductible to the point that I am only covered for near catastrophic medical events. The number of physicians I know who don't hate Obamacare is unknown, because the only comment I have ever heard about it are negative .
1
If this bill passes, the shredding of medicare could be next. It would be so much easier to look outward to others who know how to get all citizens covered, instead of looking inward at the profit/loss issue associated with every breath of the GOP. Theres the rub. If a premise is wrong, the conclusion will be useless.
The premise for the republicans in general is, lets take care of us and let all others make their own way.Long ago and far away, our country took pride in its diversity and helped those less fortunate. If we ever get to that place again, we could be Great Again.
The premise for the republicans in general is, lets take care of us and let all others make their own way.Long ago and far away, our country took pride in its diversity and helped those less fortunate. If we ever get to that place again, we could be Great Again.
3
"Their approach to Obamacare has worked quite nicely for them, until now. Lying can be an effective political tactic. Believing your own alternative facts, however, is usually not so smart."
But the base KNOWS that the alternate facts are real. For example, even as the White House walks back the accusation that Obama wiretapped Trump as recounted here int he Time (https://www.nytimes.com/2017/03/13/us/politics/kellyanne-conway-obama-mi... tens of millions of Americans 'know' that this happened.
But the base KNOWS that the alternate facts are real. For example, even as the White House walks back the accusation that Obama wiretapped Trump as recounted here int he Time (https://www.nytimes.com/2017/03/13/us/politics/kellyanne-conway-obama-mi... tens of millions of Americans 'know' that this happened.
2
Let them eat cake. Like the rest of us, let congress buy their insurance on the open market, replacing congress care with trump care! This will give them a taste of health care reality Mmm. B
Obama tried hard to get bipartisan support. And he needed every Senate Democrat to win. Thus, concessions to Ben Nelson of Nebraska that weakened the program. (Nelson later lost his seat to a conservative Republican anyway). Maine Republican Sen. Susan Collins, as usual, posed as a moderate loved by the press, exacting concessions before, voting with her party against the ACA -- also as usual. Do people not yet understand that Republicans are against domestic government programs of any kind that do not favor Big Business and the wealthy? This gives new meaning to the term "slow learner."
4
A very nice explanation of the Dog-Catches-Car example. Said differently, Republicans can no longer pivot away for their own far right position. Obamacare has filled the vacuum where a Republican health care plan should reasonably exist. They can only attempt to justify an untenable position because there's no more room to walk in either direction.
There's something I don't understand though. If Republicans knew they were caught between a rock and a hard place, why expedite health care reform? This didn't need to be priority number one. Even more mind boggling, Republicans made a very public show of themselves walking off a cliff. You don't typically draw attention to yourself when you didn't do your homework.
The Republicans spent nearly a decade talking their way around an utterly transparent lack of alternatives. I'd have thought they'd try to keep up the routine a bit longer. No one outside the Freedom caucus was really taking them to task on day one anyway. Ryan could have suggested any number of other policy priorities instead. But no, Obamacare.
Republicans deserve every bit of what's coming to them.
There's something I don't understand though. If Republicans knew they were caught between a rock and a hard place, why expedite health care reform? This didn't need to be priority number one. Even more mind boggling, Republicans made a very public show of themselves walking off a cliff. You don't typically draw attention to yourself when you didn't do your homework.
The Republicans spent nearly a decade talking their way around an utterly transparent lack of alternatives. I'd have thought they'd try to keep up the routine a bit longer. No one outside the Freedom caucus was really taking them to task on day one anyway. Ryan could have suggested any number of other policy priorities instead. But no, Obamacare.
Republicans deserve every bit of what's coming to them.
1
Thank you for this. ACA Is Bipartisan.
You don't think Democratic Committee chairmen Dingle and Rangel and Miller had other, bigger, more ambitious reforms in mind? They sure did, and HR 3200 & HR 3962, the Tri Comm bills were deemed too radical for passage and set aside.
Sens Reid was determined to pass legislation in to law and Baucus was determined that it would pay for itself This meant a less radical route: legislation that built new reforms in to what already existed, leveling the playing field for consumers, and assuring stakeholder buy-in through assurance of a large poll of insured.
Moreover, Senator Baucus spent months working with the Republican Members of his committee, meeting and discussing issues and concerns. If you look at the markup transcripts you can see that there was an ambitious and open debate in the first weeks - but this shuts down as the Republican Senators were pressured to stop being cooperative.
We could have been amending and improving ACA for the last 7 years, building on it and helping Americans. And now what?
You don't think Democratic Committee chairmen Dingle and Rangel and Miller had other, bigger, more ambitious reforms in mind? They sure did, and HR 3200 & HR 3962, the Tri Comm bills were deemed too radical for passage and set aside.
Sens Reid was determined to pass legislation in to law and Baucus was determined that it would pay for itself This meant a less radical route: legislation that built new reforms in to what already existed, leveling the playing field for consumers, and assuring stakeholder buy-in through assurance of a large poll of insured.
Moreover, Senator Baucus spent months working with the Republican Members of his committee, meeting and discussing issues and concerns. If you look at the markup transcripts you can see that there was an ambitious and open debate in the first weeks - but this shuts down as the Republican Senators were pressured to stop being cooperative.
We could have been amending and improving ACA for the last 7 years, building on it and helping Americans. And now what?
1
I sadly shake my head because as the article pointed out, and none of the Republicans are even mentioning, is the lack of attack on the insurance companies. The health care companies are the key players and yet like all stars they appear to be untouchable. Unfortunately, we did not elect Robin Hood to office. The theme of this presidency is take from the poor and give to the rich, rich white men that is.
1
Thank you, Mr. Leonhardt, for this pertinent recognition of the facts which are always absent in the rantings from Republicans like Greta Van Susteren, usually absent in the accounts from the younger TV reporters who weren't around at the beginning of ACA creation, and always absent in the railings of racists. ALL OF THE FACTS FOR THE LAST 10 YEARS CONCERNING HEALTH CARE DEVELOPMENT MUST BE PRESENTED TO THE PUBLIC IN ALL DISCUSSIONS as you have done here!
1
Did Democrats spring up to defend the ACA? Not so much. Sometimes not at all. Might not get re-elected. Did the press (what is left of it)? Not so much. GOP talking points are so much more fun and it make for a bi-partisan look. For that matter, did Hillary spend a lot of time defending the ACA? Not that I remember. Thus the GOP lies that Obamacare is in a death spiral etc. went unchallenged for the most part for eight years. It is analogous to the Dems failure to pay attention to their one-time base of white, one-time unionists. Trump was right when he said the Dems had taken their votes for granted for a generation or more and done nothing for them unless they were fashionably black, brown, or gay. They could have brought their union base home and won in 2000 and 2016 rather easily, but it is so much more rewarding to dine with Goldman, Sachs. The Clinton's had little use for unionism, perhaps because they grew up politically in an Arkansas dominated by Walmart heirs. So when the GOP in the south and lower industrial north took over the Dixiecrat Democratic wing, there was little or no attempt to re-integrate the former Democratic base into the fashionable liberal left. More than sad. Tragic for our country and the world.
1
The driver must retell the tale--it is propaganda. It is newspeak. It is alternate facts. It is distraction. It is repeat-repeat-repeat. Send it out on Facebook repeatedly and in novel ways. Celebrate ignorance by repeating it again.
Q: When will reasonable people who are concerned about our democracy--stop being courteous and surprised and work on a plan that coordinates a swift and effective rebuttal to this propaganda machine?
Q: When will reasonable people who are concerned about our democracy--stop being courteous and surprised and work on a plan that coordinates a swift and effective rebuttal to this propaganda machine?
1
Few seem to realize that we all subsidize expensive emergency room care for the uninsured, who are guaranteed treatment there and who seek that as their only means of medical care . This needs to stop!!!
1
let's just call it: "TrumpNOcare!"
"The Congressional Budget Office released a jaw-dropping report Monday estimating that the Republican health plan would take insurance from 24 million people"
My understanding from the report's conclusion is that this sentence by Mr. Leonhardt is inaccurate - because some portion of those 24 million would drop insurance voluntarily once the mandate is gone. To say that insurance will be "taken away" from those people therefore distorts the facts. When I read inaccurate, politicized statements like this I ignore the rest of the writer's piece as untrustworthy. It wouldn't matter if 23 of the 24 million literally would have insurance "taken" from them. The statement is still exaggerated for the obvious purpose of supporting Mr. Leonhardt's political views - not to further the truth.
My understanding from the report's conclusion is that this sentence by Mr. Leonhardt is inaccurate - because some portion of those 24 million would drop insurance voluntarily once the mandate is gone. To say that insurance will be "taken away" from those people therefore distorts the facts. When I read inaccurate, politicized statements like this I ignore the rest of the writer's piece as untrustworthy. It wouldn't matter if 23 of the 24 million literally would have insurance "taken" from them. The statement is still exaggerated for the obvious purpose of supporting Mr. Leonhardt's political views - not to further the truth.
1
After 25 years of he Republican Party undermining the public discourse by reflexively lying for short term gain, pretending that this is an issue of being merely wrong doesn't quite cut it. This is a campaign of willful deception and pretending otherwise is to be complicit in it. We've been patient way too long, pretending that eventually the better argument will win out. It won't. There is non plausible deniability left.
1
The Republicans can't "put up" and they won't "shut up." Because they painted themselves into a political corner we all have to suffer? Well, almost all, Not the very rich, of course. A wise GOP leadership would repair, rename and move on to some things in this country that really need attention. The ACA was a version of Romneycare to begin with. But no. The same individuals who can't bring themselves to tell the president he has no clothes will easily tell us we have no healthcare insurance. Their karmic payback will be interesting to watch...as long as I'm healthy.
1
The Republicans never expected to take over the entire government. They figured that they would keep opposing Obamacare forever with the Democrats always blocking any change. Sweet.
However, the disaster happen and they took over the government, House, Senate, President. Now they are trapped by their own lies.
However, the disaster happen and they took over the government, House, Senate, President. Now they are trapped by their own lies.
We are beyond being lied to by these destructive partisans.
Is it any surprise that Trump would sign off on getting rid of programs that promote links with the health care system and minority communities to address chronic disease and risk factors?
To eliminate childhood lead poisoning? To eliminate outbreaks of food-borne infections and water-borne diseases?
Or end programs that kick start the ability of state, local, and territorial capacity for detecting/responding to public health threats such as infectious diseases?
These wretched Republicans also end programs for Alzheimer's Disease, dementia and memory loss with this bill.
And chronic disease self-management programs--which help people stay independent for longer periods.
Are they just blindly cutting anything that says Obama?
Is it any surprise that Trump would sign off on getting rid of programs that promote links with the health care system and minority communities to address chronic disease and risk factors?
To eliminate childhood lead poisoning? To eliminate outbreaks of food-borne infections and water-borne diseases?
Or end programs that kick start the ability of state, local, and territorial capacity for detecting/responding to public health threats such as infectious diseases?
These wretched Republicans also end programs for Alzheimer's Disease, dementia and memory loss with this bill.
And chronic disease self-management programs--which help people stay independent for longer periods.
Are they just blindly cutting anything that says Obama?
The flaw is with the whole notion of government-controlled heathcare. Far from improving things, Obama care exacerbated an already flawed situation. But, as bad as things were, there are worse under Obamacare. Obama lied; many people were not allowed to keep their plans or their doctors. Many thousands of people lost their insurance, and those who were able to keep it, ended up paying more for less. The only "winners" were as a result of expanding Medicaid. But even there the "win" is chimerical: more and more doctors and hospitals are opting out of Medicare and Medicaid.
So what should be done? A "clean" repeal of Obamacare restoring the status quo ante, with an effective date one year from passage to give Congress time to develop a truly bi-partisan replacement.
So what should be done? A "clean" repeal of Obamacare restoring the status quo ante, with an effective date one year from passage to give Congress time to develop a truly bi-partisan replacement.
Great article! What was the last large scale public benefit program you can remember the Republicans proposing and passing? Repubs should just be honest and tell the American people they hate the very concept of increasing the public welfare with government programs. And live with the political consequences of that truth. Instead their new leader in his willful ignorance of government and economics blissfully shackled them to the socialist promise of humane health-care for all... just to win the election. It's like a combining physics and astrology. The internal contradictions are safe so long as it doesn't have to work in a big way.
But now Republicans are charged with building something, not tearing down someone else's sincere effort to benefit the public. Time to choose, Paul and Donald. Physics or astrology? No more 'best of both worlds.'
But now Republicans are charged with building something, not tearing down someone else's sincere effort to benefit the public. Time to choose, Paul and Donald. Physics or astrology? No more 'best of both worlds.'
2
It is Romneycare. Republicans were zombiefied by McConnell's Stop Obama At Any Cost. 24 million thrown out on the streets. If capitalism is endangered it is the genocides of war and lack of domestic health and human services coupled with entitlements to the rich who benefit from trusts and shady business accounts along with tax cuts and loopholes keeping them and their families in control of Citizens United which assures the uber rich of never losing power over their wealth and political standing.
The latest moves to incarcerate an imported work force by these crowned heads of state int their own jails for profit mirror Betsey DeVoe's brother Erik Prince who sent the American taxpayer invoices for billions of dollars in services rendered for jobs Dick Cheney manufactured for him and Haliburton in Iraq. Everyone is scrambling to replicate Erik Prince's genius move to bilk the taxpayer, create themselves a throne in the hall of the crown heads and send out big fat invoices to you and me while elected republicans peel them a grape.
Cutting healthcare to 24 million just brings more pheasant under glass for those lined up to be seated, and my advise to them? Learn Russian. It will will make conversation easier between courses.
The latest moves to incarcerate an imported work force by these crowned heads of state int their own jails for profit mirror Betsey DeVoe's brother Erik Prince who sent the American taxpayer invoices for billions of dollars in services rendered for jobs Dick Cheney manufactured for him and Haliburton in Iraq. Everyone is scrambling to replicate Erik Prince's genius move to bilk the taxpayer, create themselves a throne in the hall of the crown heads and send out big fat invoices to you and me while elected republicans peel them a grape.
Cutting healthcare to 24 million just brings more pheasant under glass for those lined up to be seated, and my advise to them? Learn Russian. It will will make conversation easier between courses.
1
The problem with Obamacare is Republicans in elective office. All the flaws and complaints about Obamacare could be addressed and remedied if Republicans did not stand in the way. They serve their own interests, not America's interests.
There is no such thing as "moderate Republican." That is an oxymoron. For example, pundits often describe Senator Susan Collins as a moderate Republican. Well if voting 1 percent of the time in the interests of the country, while voting 99 percent of the time in the interests of her party makes her a moderate Republican, then by the same stretch of the imagination, Donald Trump is Lincolnesque in his compassion and humility.
There is no such thing as "moderate Republican." That is an oxymoron. For example, pundits often describe Senator Susan Collins as a moderate Republican. Well if voting 1 percent of the time in the interests of the country, while voting 99 percent of the time in the interests of her party makes her a moderate Republican, then by the same stretch of the imagination, Donald Trump is Lincolnesque in his compassion and humility.
1
Why go through these policy contortions? Some Republicans are doubtless horrified by the prospect of providing health care for people who don't earn enough to pay for it in the U.S., but the real animus against Obamacare, among those who matter, is the taxes it imposes on the wealthy.
Repeal/replace is just another regressive tax cut bill. That's it, but that's also all it takes for a Republican, no matter how dire the consequences. The rest is blather.
Repeal/replace is just another regressive tax cut bill. That's it, but that's also all it takes for a Republican, no matter how dire the consequences. The rest is blather.
1
And the lies continue. Trump/Ryan/Price Non Healthcare has hidden costs that have not been discussed. But they could, if not addressed, and clearly understood, lead to a disruption in Medicare...a system that so far, has been left out of the healthcare "do over" insanity.
By cutting Medicaid and reducing subsidies for low income Medicare costs will be impacted offsetting any "savings". . Why? Because at age 65 Medicare eligibility begins. People who have not had insurance for the last several years, as a result of the Trump/Ryan/Price Plan and not had the means to see a doctor, will, with their new found Medicare coverage, all of sudden show up at the doctors office. Alot of them will be sick. Most of the illnesses will have progressed and could have been dealt with early had the person had medical insurance. So, there may be catastrophic increases in Medicare costs off setting any savings to the deficit contained in the CBO. Reduce that 300 billion savings to zero.
Providing seniors with healthcare is expensive. Medicare, so far, picks up the tab for us geezers 65 and up. But, so far, shaky as it is, there has been a sort of continuum of care, from employer group and individual healthcare plans, that people are enrolled in to Medicare. Create a gap in that care by pulling the rug out for 2-3 years or more and there will be a price to pay.
By cutting Medicaid and reducing subsidies for low income Medicare costs will be impacted offsetting any "savings". . Why? Because at age 65 Medicare eligibility begins. People who have not had insurance for the last several years, as a result of the Trump/Ryan/Price Plan and not had the means to see a doctor, will, with their new found Medicare coverage, all of sudden show up at the doctors office. Alot of them will be sick. Most of the illnesses will have progressed and could have been dealt with early had the person had medical insurance. So, there may be catastrophic increases in Medicare costs off setting any savings to the deficit contained in the CBO. Reduce that 300 billion savings to zero.
Providing seniors with healthcare is expensive. Medicare, so far, picks up the tab for us geezers 65 and up. But, so far, shaky as it is, there has been a sort of continuum of care, from employer group and individual healthcare plans, that people are enrolled in to Medicare. Create a gap in that care by pulling the rug out for 2-3 years or more and there will be a price to pay.
Nice summary, Mr. Leonhardt. Here is another thing---the Republicans were so interested in capitalizing on the extreme right wing hatred of anything Obama, that they missed a true conservative opportunity to steer health financing in America in a conservative direction. Had Mr. Ryan really wanted to privatize Medicare, he might have supported the idea of transferring all Medicare folks to the private insurance markets of the ACA with means tested subsidies for the poor, a private competitive market with no government option. As it is, it appears that the Republicans have proposed something that their own folks are going to hate, that will pave the way ultimately for some kind of single payer system---they will have overcome the resistance of the AMA and AHA to such a plan by proposing something worse. Congratulations. The Republicans are true to conservative principles at about the same level as the evangelicals are to the teachings of Jesus. This is what happens when you turn your conservative strategies over to brilliant minds like Hannity, Rush, Alex Jones et al. And elect a President who is simply a front clown for a maniac who is interested in destroying our ability to put social policies in place.
1
"Obamacare is the bipartisan version of health reform."
Absolutely correct. At the time of the battle, most of us would have opted for some form of a single-payer system. Personally, I would have started with something like Medicare for all, but I don't have to deal with politicians. President Obama went for what he could get (it was close!), hoping that at least some Republicans would support a plan that was essentially their own and was purported to have been successful in Mass.
In short, Obamacare was a massive compromise, and, as such, bipartisan -- except Republicans decided to reject both their own plan and bipartisanship.
Absolutely correct. At the time of the battle, most of us would have opted for some form of a single-payer system. Personally, I would have started with something like Medicare for all, but I don't have to deal with politicians. President Obama went for what he could get (it was close!), hoping that at least some Republicans would support a plan that was essentially their own and was purported to have been successful in Mass.
In short, Obamacare was a massive compromise, and, as such, bipartisan -- except Republicans decided to reject both their own plan and bipartisanship.
1
Price summed up the AHCA would ensure that families would not be hurt financially, which is very true except they also would not have health care either.
Ryan boasted about the freedom of choice, Americans will be free to choice which ever healthcare policy they can afford.
The GOP's plan allows for tax deductions and health care savings accounts instead of subsidies. There is a very real difference is these elements with people who live paycheck to paycheck. Subsidies come from the Government applied to the cost of the healthcare. Tax deductions are applied when you pay your yearly income tax due on April 15th.
Health Savings Accounts are monies earmarked from your paycheck to be put aside for your healthcare. The only problem is it comes from moneys that people need to live week to week.
The GOP's plan also gives the affluent a "huge" tax cut, this does nothing to help the poor but this group provides the money for actual Republican support.
For the truly poor, all Government support for Medicaid will be removed and the States will receive block grants. These block grants are much less then the Government would pay and States have the right to determine who would receive this limited benefits.
The mandates would be removed to prompt the young to buy healthcare, instead if you allow your policy to lapse, after two month the cost will be 30% more.
This in reality is not a healthcare plan at all but a death notice.
Ryan boasted about the freedom of choice, Americans will be free to choice which ever healthcare policy they can afford.
The GOP's plan allows for tax deductions and health care savings accounts instead of subsidies. There is a very real difference is these elements with people who live paycheck to paycheck. Subsidies come from the Government applied to the cost of the healthcare. Tax deductions are applied when you pay your yearly income tax due on April 15th.
Health Savings Accounts are monies earmarked from your paycheck to be put aside for your healthcare. The only problem is it comes from moneys that people need to live week to week.
The GOP's plan also gives the affluent a "huge" tax cut, this does nothing to help the poor but this group provides the money for actual Republican support.
For the truly poor, all Government support for Medicaid will be removed and the States will receive block grants. These block grants are much less then the Government would pay and States have the right to determine who would receive this limited benefits.
The mandates would be removed to prompt the young to buy healthcare, instead if you allow your policy to lapse, after two month the cost will be 30% more.
This in reality is not a healthcare plan at all but a death notice.
1
The biggest problem with the ACA is that President Obama tried to do the bipartisan thing. Republicans lied from the very beginning, adhering to their pledge to McConnell to oppose any proposals by President Obama. Their goal was a one-term President. Let us not ever forget Republicans from the get-go were out to destroy Barack Obama.
The GOP did everything to sabotage the ACA, to make its failure a self-fulfilling prophecy. See, they would say, we told you "socialize medicine" wouldn't work. We were right, Obama was wrong.
The truth is all First World nations have better health care coverage which works well, and costs less. But to do so one must accept the notion that the sum is greater than its parts, that Socialism, where Society pulls together for a common purpose, is indeed better than each individual fending for themselves. Insurance's secret to success has always been the same: the larger the pool of insured the greater the benefits and the lower the costs. That means a real universal Federally-run program, a Fed Med Care Plan. If this country actually had such a program people would flock to it. It would be this large pool of people who would have immense clout. Republicans are against this idea because it would prove their theories of free market capitalism wrong. They fight because they refuse to admit the obvious, the plan, as their ideas, are theories which have no basis in reality. Maybe that's why they voted for a Reality TV huckster.
DD
Manhattan
The GOP did everything to sabotage the ACA, to make its failure a self-fulfilling prophecy. See, they would say, we told you "socialize medicine" wouldn't work. We were right, Obama was wrong.
The truth is all First World nations have better health care coverage which works well, and costs less. But to do so one must accept the notion that the sum is greater than its parts, that Socialism, where Society pulls together for a common purpose, is indeed better than each individual fending for themselves. Insurance's secret to success has always been the same: the larger the pool of insured the greater the benefits and the lower the costs. That means a real universal Federally-run program, a Fed Med Care Plan. If this country actually had such a program people would flock to it. It would be this large pool of people who would have immense clout. Republicans are against this idea because it would prove their theories of free market capitalism wrong. They fight because they refuse to admit the obvious, the plan, as their ideas, are theories which have no basis in reality. Maybe that's why they voted for a Reality TV huckster.
DD
Manhattan
Mr. Leohardt,
Your article is titled, "The Original Lie About Obamacare." But your article doesn't expose the original lie. So, let me do it here for the readers.
The original lie is found in the name of the act itself in that it's called the AFFORDABLE Care Act (ACA). And, the Act has proven to be anything but affordable but not for the reasons most people cite, insurer greed.
Indeed, the Act capped insurers' profits at 20% of the claims costs. If the insurers make more profit than 20% of claims costs they must reimburse their members (enrollees) year-end in amounts what would bring their profits on their medical insurance products sold under the ACA (not other products like life and critical illness) to no more than 20%.
So, if the original lie was that health care would be affordable, what happened to make it un-affordable? Well, that's very simple if you think even one moment about it. The ACA contained no meaningful cost control measures which bound the medical arts providers (doctors, hospitals, pharmaceutical houses, biomedical device corporations, laboratories and clinics). And, the cap on the profits of the insurers at 20% of claim's costs encouraged the insurers to go light on the providers' costs too as a percentage slice of a big pie (high claims) was more than the same percentage slice of a smaller pie (lower claims).
So, there was a disincentive for the insurers to enforce cost controls on their providers. And, providers grossly overcharged.
LF
Your article is titled, "The Original Lie About Obamacare." But your article doesn't expose the original lie. So, let me do it here for the readers.
The original lie is found in the name of the act itself in that it's called the AFFORDABLE Care Act (ACA). And, the Act has proven to be anything but affordable but not for the reasons most people cite, insurer greed.
Indeed, the Act capped insurers' profits at 20% of the claims costs. If the insurers make more profit than 20% of claims costs they must reimburse their members (enrollees) year-end in amounts what would bring their profits on their medical insurance products sold under the ACA (not other products like life and critical illness) to no more than 20%.
So, if the original lie was that health care would be affordable, what happened to make it un-affordable? Well, that's very simple if you think even one moment about it. The ACA contained no meaningful cost control measures which bound the medical arts providers (doctors, hospitals, pharmaceutical houses, biomedical device corporations, laboratories and clinics). And, the cap on the profits of the insurers at 20% of claim's costs encouraged the insurers to go light on the providers' costs too as a percentage slice of a big pie (high claims) was more than the same percentage slice of a smaller pie (lower claims).
So, there was a disincentive for the insurers to enforce cost controls on their providers. And, providers grossly overcharged.
LF
Lots of good comments here expanding upon this original lie, which is 100% dead on. Anyone remember Olympia Snowe, Susanne Collins? They were totally on board until Yurtle McTurtle decided "bipartisanship" was bad for his party. People act as though there is no record of these things. The "Elections have consequences, John" comment that conservatives love to hate...from an Obamacare working group meeting that was televised on CSPAN.
The other big lie is why Obamacare is failing in the first place. Notice that Republican governors in several states refused to participate in the Medicare expansion, which would have taken pressure off of the exchange plans. If all those states had participated by taking what was effectively free money from the Feds, perhaps the exchanges wouldn't be crowded with poor and sick people and premiums would be low enough to attract young people. THIS is the lie that no one is talking about. Obamacare is failing because that is exactly what republicans wanted, to deny a Democratic president any sort of a victory even if it was in the best interest of the citizens of their own states. Now everyone has to live with uncertainty, which all businesses just love.
The other big lie is why Obamacare is failing in the first place. Notice that Republican governors in several states refused to participate in the Medicare expansion, which would have taken pressure off of the exchange plans. If all those states had participated by taking what was effectively free money from the Feds, perhaps the exchanges wouldn't be crowded with poor and sick people and premiums would be low enough to attract young people. THIS is the lie that no one is talking about. Obamacare is failing because that is exactly what republicans wanted, to deny a Democratic president any sort of a victory even if it was in the best interest of the citizens of their own states. Now everyone has to live with uncertainty, which all businesses just love.
One wonders how Tom Price, who apparently did very well as a physician, can look at himself in the mirror. He will never have to worry about paying for health care for himself or his family - his net worth is estimated to be $13 million. But apparently he has forgotten the following phrase of the modern Hippocratic Oath:
"I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability."
Today's middle class and poor families most certainly are affected by illness and accidents that require extended and/or intensive treatment. Mr. Price would do well to remember this, and to alleviate the suffering of these families by doing all he can, as a physician and now as the Secretary of Health and Human Services. Doing all he can does not mean throwing the baby out with the bathwater by "repealing and replacing" the ACA instead of trying fix the parts that don't work just out of spite for Obama and Democrats. Shameful.
"I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability."
Today's middle class and poor families most certainly are affected by illness and accidents that require extended and/or intensive treatment. Mr. Price would do well to remember this, and to alleviate the suffering of these families by doing all he can, as a physician and now as the Secretary of Health and Human Services. Doing all he can does not mean throwing the baby out with the bathwater by "repealing and replacing" the ACA instead of trying fix the parts that don't work just out of spite for Obama and Democrats. Shameful.
2
And today, the White House's daily email called "Your 1600 Daily," says that "President Donald J. Trump is committed to delivering relief to Americans struggling under the weight of Obamacare's rising prices and onerous mandates. The President's reforms will bring down costs and increase access to coverage for millions of Americans. It's time to repeal the disaster known as Obamacare and replace it with a system that puts the interests of the people first."
These strident falsehoods repeated over and over seem to gain credence and force with each repetition. I wish there were equally simple and forceful statements the Democrats could consistently make to counter this assault.
How about: Obamacare has saved thousands of lives and brought peace of mind to millions of Americans. The health care reform adopted by Republican Mitt Romney in Massachusetts has worked very well since 2006, which is why Obamacare was modeled after it.
These strident falsehoods repeated over and over seem to gain credence and force with each repetition. I wish there were equally simple and forceful statements the Democrats could consistently make to counter this assault.
How about: Obamacare has saved thousands of lives and brought peace of mind to millions of Americans. The health care reform adopted by Republican Mitt Romney in Massachusetts has worked very well since 2006, which is why Obamacare was modeled after it.
3
As usual, David Leonhardt gets to the heart of the matter. Claiming supposed concern for the disaffected and financially strapped, Republican leadership has nonetheless withdrawn from any bipartisan efforts to forge a healthcare system that is tenable for all Americans. Cynical disengagement masked by vaporous platitudes has rendered the Republicans a party of greed and selfishness. Without seeking common ground under the Constitutional directive to establish justice--for equal right to healthcare is an element of social justice--Republicans are on a path to oblivion.
1
Why does everyone think Medicare is free? We pay $404 for Medicare as well as $160 for supplemental and another $30 for a drug plan monthly. Each. And we've been paying into Medicare for decades by deductions. Thought the term entitlement seems to imply that people are entitled to something they did not pay into, the true meaning is that one is entitled to it because we paid for it and therefore it cannot be taken away.
1
In "The Empire of Cotton," Sven Beckert documents the emergence of a soft slavery that ensured capitalists a compliant workforce in their home countries that mirrored the slavery they imposed on foreign workers. Over time, healthcare became a primary means to compel workers to remain in the employ of otherwise oppressive corporations who underpaid and overworked them. The seemingly absurd claim that Medicare would be the end of capitalism is not so far fetched in light of the historical norms of global industrial capitalism. It is why Republicans can't allow national healthcare to persist in America.
119
A successful business friend of mine, a Trump supporter, made this comment to me regarding the current health care mess: trust me (he always begins his comments with trust me), the Republicans mistake was making this personal, never make a business decision a personal one. From the beginning, Ryan/McConnell and their party disliked the president, that made his entire presidency into a personal vendetta. Instead of carefully analyzing Obamacare, looking for ways they might take credit for improving it, they could never see beyond demonizing the President--they made Obamacare personal. When it came time to look at Obamacare from a business standpoint, it was too late, they had so personalize their disdain for the President, that they could not stand back and objectively create a better version of the bill---
304
The death of Obamacare isn't something to lament. The best, most effective system of healthcare we could devise would be universal healthcare, and Obamacare isn't universal healthcare and it isn't likely to be able to morph into universal healthcare at a later date. Obamacare is an attempt to create American-style socialism, which is a system of state capitalism where a few large conglomerates receive directives from the central, bureaucratic authority. Think the pentagon system with the defense contractors, the department of agriculture and agribusiness, or, in many ways, the federal reserve system and the banks. Typically, the republicans and the right love state-capitalism, but I guess when it comes to national health they draw a line. Had Obamacare succeeded and had it been permitted to remain as it was devised, then, with a few tweaks, I think the big insurers would have come to have loved it and their lobbying clout would have killed any chance that it would have been altered, even over the objections of the small business that the right feels the need to pay lip service to in order to get their people into office.
The American healthcare system has been violated by government, and the AMA, since the 1800s. Our healthcare system has never been operated as a free market in living memory - yet no one wants to try that.
Government regulations have done catastrophic damage to the healthcare system, which is the exact reason why healthcare is expensive and nearly impossible to navigate. Perverse incentives guaranteed by deranged bureaucratic interference brought on by government diktat are the result.
If you want cheaper, better, and greater healthcare - get rid of government interference. And especially deny the authority of the AMA, whose primary purpose as stated in the original charter is "to raise the income of doctors".
Neither Ds nor Rs are interested in removing government interference in the healthcare system - because lobbyists from the AMA and pharma and insurance companies find it easier to be blackmailed by politicians than to actually have to compete. Once politicians took away the need to compete, American healthcare expenses skyrocketed.
Government regulations have done catastrophic damage to the healthcare system, which is the exact reason why healthcare is expensive and nearly impossible to navigate. Perverse incentives guaranteed by deranged bureaucratic interference brought on by government diktat are the result.
If you want cheaper, better, and greater healthcare - get rid of government interference. And especially deny the authority of the AMA, whose primary purpose as stated in the original charter is "to raise the income of doctors".
Neither Ds nor Rs are interested in removing government interference in the healthcare system - because lobbyists from the AMA and pharma and insurance companies find it easier to be blackmailed by politicians than to actually have to compete. Once politicians took away the need to compete, American healthcare expenses skyrocketed.
1
There's just something about Republicans hostile policies against government providing services to its people that doesn't add up.
Republicans claim government is too big, too expensive, can't do anything right, chooses winners and losers, on and on. Their solution to the perceived problems is always to privatize these services. Basically adding a for-profit middleman into the formula. Uncle Sam still ponies up the tax dollars to pay. But what are the savings? Military contractors costing $150,000 versus Marines or Army enlistees at one third the cost? Private prisons charging $35,000 a bed to house non violent offenders?
And health insurance companies controlling the money end of a health care sector that (in its current form) costs the U.S. 17.6% of GDP compared to universal systems of OECD countries which run, on average, at 9.5% of GDP. The bloated Republican-forced health care system in the U.S. costs 8% (more) of GDP and doesn't cover all Americans. Not even close!
Compared to well run, functioning OECD systems, the waste in the Republican U.S. health care model (8% GDP) is roughly DOUBLE the entire U.S. military budget (4%GDP).
It is way past time to get rid of the expensive for-profit insurance middlemen and go to taxpayer-direct universal health care.
Republicans claim government is too big, too expensive, can't do anything right, chooses winners and losers, on and on. Their solution to the perceived problems is always to privatize these services. Basically adding a for-profit middleman into the formula. Uncle Sam still ponies up the tax dollars to pay. But what are the savings? Military contractors costing $150,000 versus Marines or Army enlistees at one third the cost? Private prisons charging $35,000 a bed to house non violent offenders?
And health insurance companies controlling the money end of a health care sector that (in its current form) costs the U.S. 17.6% of GDP compared to universal systems of OECD countries which run, on average, at 9.5% of GDP. The bloated Republican-forced health care system in the U.S. costs 8% (more) of GDP and doesn't cover all Americans. Not even close!
Compared to well run, functioning OECD systems, the waste in the Republican U.S. health care model (8% GDP) is roughly DOUBLE the entire U.S. military budget (4%GDP).
It is way past time to get rid of the expensive for-profit insurance middlemen and go to taxpayer-direct universal health care.
7
Well, this is my 4th post today on different articles and I didn't see one of them.
What needs to be said is that Trump started out his campaign with a big lie.
He repeatedly promised that he would not cut Medicaid.
In May 2015, while preparing for his campaign as a primary candidate, he said, “I’m not going to cut Medicare or Medicaid. Every other Republican is going to cut.”
Fast forward to today:
The CBO report reveals what Trump promised is absolutely false, because Trump supports a plan that would include very deep and painful Medicaid cuts.
Poor and older Americans will be out in the cold. Aging Americans are out of luck in Trump's world of towers, palaces and summer homes.
According to the CBO, a 64-year-old earning a mere $20,000 yearly would see her insurance premiums rise from $1,700 to $14,600 under the Republican plan — that is a whopping 758 % increase.
More than half her yearly income would go to health insurance. Might as well get out and replay those television ads of Paul Ryan pushing a woman over the cliff in her wheelchair. It's as bad as Romney/Ryan 2012.
What needs to be said is that Trump started out his campaign with a big lie.
He repeatedly promised that he would not cut Medicaid.
In May 2015, while preparing for his campaign as a primary candidate, he said, “I’m not going to cut Medicare or Medicaid. Every other Republican is going to cut.”
Fast forward to today:
The CBO report reveals what Trump promised is absolutely false, because Trump supports a plan that would include very deep and painful Medicaid cuts.
Poor and older Americans will be out in the cold. Aging Americans are out of luck in Trump's world of towers, palaces and summer homes.
According to the CBO, a 64-year-old earning a mere $20,000 yearly would see her insurance premiums rise from $1,700 to $14,600 under the Republican plan — that is a whopping 758 % increase.
More than half her yearly income would go to health insurance. Might as well get out and replay those television ads of Paul Ryan pushing a woman over the cliff in her wheelchair. It's as bad as Romney/Ryan 2012.
7
As a retired small business owner who once employed over 30 people, I can tell you that many American workers have a skewed idea of how medical insurance works. Many of our employees found it difficult to accept the basic premise of health insurance: It is protection to ensure an illness or accident does not wipe out your life's savings. In contrast, many of our employees felt that our medical insurance plan was essentially a first-dollar subsidy of all their medical costs. They preferred a zero deductible plan and could not understand why our company could not afford one. The costs of such a plan were simply prohibitive.
The Affordable Care Act tried to reconcile these conflicting perspectives. But in truth, they cannot be reconciled in a market economy. This new Trumpcare plan only makes a weak solution worse. A single payer plan is what most Americans really want. But the Republican propaganda machine has poisoned their minds against it.
The Affordable Care Act tried to reconcile these conflicting perspectives. But in truth, they cannot be reconciled in a market economy. This new Trumpcare plan only makes a weak solution worse. A single payer plan is what most Americans really want. But the Republican propaganda machine has poisoned their minds against it.
2
Healthcare is a crisis in our society.
And perhaps we are at a critical moment and are finally willing to face the problem.
Perhaps the potential exists for us to revisit this part of the social contract and ask ourselves a fundamental question: What rightfully, justly ought to be included in the responsibility we share as members of this society for the care of each other as human beings and citizens? Healthcare?
If health is to be included in our mutual care, then ought not everyone--every single one of us--participate in both the benefit and the cost? No exceptions; no more or less privileged categories of persons and conditions; no higher or lower tiers of quality, access, or coverage; no calculations of political advantage or financial gain; no 'free market'/'socialism' red herrings; no lies; no mind-numbing slogans; no manipulations of numbers or emotions. Is there any one of us who is not part of the whole?
But at least let us be brutally honest: At root, either we weight this crisis in favor of the care of our health or we weight it in favor of the distribution of our money.
And perhaps we are at a critical moment and are finally willing to face the problem.
Perhaps the potential exists for us to revisit this part of the social contract and ask ourselves a fundamental question: What rightfully, justly ought to be included in the responsibility we share as members of this society for the care of each other as human beings and citizens? Healthcare?
If health is to be included in our mutual care, then ought not everyone--every single one of us--participate in both the benefit and the cost? No exceptions; no more or less privileged categories of persons and conditions; no higher or lower tiers of quality, access, or coverage; no calculations of political advantage or financial gain; no 'free market'/'socialism' red herrings; no lies; no mind-numbing slogans; no manipulations of numbers or emotions. Is there any one of us who is not part of the whole?
But at least let us be brutally honest: At root, either we weight this crisis in favor of the care of our health or we weight it in favor of the distribution of our money.
1
I am convinced that many people in the U.S. are still just angry/feel threatened by Obama's election, and the stream of things in our culture which have gained support, such as gay marriage, the survival of ACA (until now,) and the clear support from the mainstream press for progressive policies. President Trump rode that reactive wave to the White House, of course. Our culture still has some "growing up" to do (see David Brooks' column today) regarding the fact that we could have the resources to take care of each other, if we could accept that "we are better together." The current administration is an embarrassment, to be sure, but worse: it is dangerous. Our competitors and enemies in the world are going to steal a march on us while we are hobbled by a reactionary administration. Trump's grass roots supporters were sold a bill of goods because of their parochialism and naivete. Now it appears most Trump supporters will actually be among the most hurt by the reactionaries in the Administration. Well, Dems, get ready and get organized. Maybe the next swing to the left will finally be the one that brings us into the progressive agenda most people really want, if they think about it. (We all want employment, health, terrpr, inequality, natural disasters to be mitigated instead of being left on our own.) But fearful conservatives need to be acknowledged, and reassured by helping them understand why everything is going to be OK. "We're better together." America is indeed great.
2
The “Original Lie About Obamacare” is that it would…and could meet expectations. Obamacare was another for-profit, Rube Goldberg, private insurance attempt to solve a public responsibility – provide every American with beneficial health care at a reasonable cost to our society. It is fairy tale belief system destined to fail in the real world.
That’s the problem. The lie is that we can use our private for-profit insurance model which relies on “market driven factors” to solve the problem. It can’t be done.
And so a very naïve President passed a bill that he could pass, which was structurally unworkable and politically indefensible.
It was the dumbest congressional action in my lifetime. With one stoke of the pen, Democrats owned our dysfunctional healthcare system that for over 80 years previous Democratic Administrations had claimed was inhuman.
Within one congressional election cycle Democrats lost the House and state legislatures nationwide. Since Obamacare was rolled out in 2013, Democrats have lost the Senate, and now the Presidency.
Paraphrasing Pres. Bush….”Obama, you did a heckuva job!”
That’s the problem. The lie is that we can use our private for-profit insurance model which relies on “market driven factors” to solve the problem. It can’t be done.
And so a very naïve President passed a bill that he could pass, which was structurally unworkable and politically indefensible.
It was the dumbest congressional action in my lifetime. With one stoke of the pen, Democrats owned our dysfunctional healthcare system that for over 80 years previous Democratic Administrations had claimed was inhuman.
Within one congressional election cycle Democrats lost the House and state legislatures nationwide. Since Obamacare was rolled out in 2013, Democrats have lost the Senate, and now the Presidency.
Paraphrasing Pres. Bush….”Obama, you did a heckuva job!”
1
You know the Rs are stupid when they, as confirmed, conservative, capitalists don't understand or believe the law of limiting returns. Henry Ford certainly understood that if he wanted to sell more cars, he needed to pay workers enough so they could afford his cars.
The insurance industry salivates at the prospect of all the money they think they are going to make under this "let them eat cake" plan, as are the Rs that think they are going to balance the budget on it. They don't want you and me to see the consequences to those plans as they cut the availability of insurance and increase its costs while removing the requirement for companies to provide health insurance. Small businesses employ at least 50% of the workers in this country. First 54 million, 20% of the population, will not be buying insurance. Then another 20% or more who will not afford insurance after their employers eliminate it. The young, healthy people, another 20% perhaps, will not buy insurance because they don't have to. With 60% of the country not buying health insurance, the premiums for those that are left will be out of sight. How are the insurance companies going to make money?
The government may not pay to keep people healthy but it sure will pay to treat them in emergency rooms and to bury them all, who will have exhausted their funds before they died. As the population shrinks, who will all those Republican Capitalists sell to? All this is the perfect law of limiting returns proof.
The insurance industry salivates at the prospect of all the money they think they are going to make under this "let them eat cake" plan, as are the Rs that think they are going to balance the budget on it. They don't want you and me to see the consequences to those plans as they cut the availability of insurance and increase its costs while removing the requirement for companies to provide health insurance. Small businesses employ at least 50% of the workers in this country. First 54 million, 20% of the population, will not be buying insurance. Then another 20% or more who will not afford insurance after their employers eliminate it. The young, healthy people, another 20% perhaps, will not buy insurance because they don't have to. With 60% of the country not buying health insurance, the premiums for those that are left will be out of sight. How are the insurance companies going to make money?
The government may not pay to keep people healthy but it sure will pay to treat them in emergency rooms and to bury them all, who will have exhausted their funds before they died. As the population shrinks, who will all those Republican Capitalists sell to? All this is the perfect law of limiting returns proof.
Exceptionally clear is that ObamaCare was originally intended as a bipartisan effort but also clear is that Republicans were more interested in power than solutions. Clear as well is that too many fail to understand that health care is simply too expensive for it to work like a used car market. We can sell junkers that actually barely run to poor people. Health care simply doesn't work that way. We can rent hovels to poor people and sell them rice and beans, but health care doesn't work that way. We subsidize busing, Medicare, public schools, roads, bridges, and so much more because, somehow, we understand that the common good is unaffordable to the poor. That common good is served by meeting common standards....by mandate.
ObamaCare needs some fixes. One is that the mandate to be covered needs to be a lot stronger. We have a mandate for Social Security but it is stronger in the sense that if a person does put in his/her 40 quarters of work, there are no benefits. Health care emergencies are mandated to be cared for as a human right, but no targeted tax covers that. We are mandated to submit income tax returns, to have drivers' licenses if we drive, etc. A sufficient personal responsibility is part of our citizen duty. That should includes a mandate to have health insurance, even if we have to subsidize a good number of folks.
ObamaCare needs some fixes. One is that the mandate to be covered needs to be a lot stronger. We have a mandate for Social Security but it is stronger in the sense that if a person does put in his/her 40 quarters of work, there are no benefits. Health care emergencies are mandated to be cared for as a human right, but no targeted tax covers that. We are mandated to submit income tax returns, to have drivers' licenses if we drive, etc. A sufficient personal responsibility is part of our citizen duty. That should includes a mandate to have health insurance, even if we have to subsidize a good number of folks.
1
This was a hastily pastiched insurance plan to primarily provide:
1. Tax cuts for those making over $200,000
2. Bonuses for insurance companies
3. A sop to the "Replace" portion of "repeal and Replace"
Note: The one thing unmentioned by the GOP is any discussion as to how they can provide the best and most affordable health care to their constituents. Nope. Unimportant. Ryan said the numbers were unimportant to him in referring to those who will be no longer included.
Note: The rest of the world has already decided. Basic health care is a citizen's right. Only in the US do we consider it a luxury we each have to pay for.
McConnell's scorched earth partisanship did indeed regain government for the GOP while destroying their ability to govern. My one consolation is that McConnell will forever have the millstone of Trump tied around his neck--to his shame.
1. Tax cuts for those making over $200,000
2. Bonuses for insurance companies
3. A sop to the "Replace" portion of "repeal and Replace"
Note: The one thing unmentioned by the GOP is any discussion as to how they can provide the best and most affordable health care to their constituents. Nope. Unimportant. Ryan said the numbers were unimportant to him in referring to those who will be no longer included.
Note: The rest of the world has already decided. Basic health care is a citizen's right. Only in the US do we consider it a luxury we each have to pay for.
McConnell's scorched earth partisanship did indeed regain government for the GOP while destroying their ability to govern. My one consolation is that McConnell will forever have the millstone of Trump tied around his neck--to his shame.
3
Health insurance can never be an efficient market good. It is monopolistic by nature, and monopolies limit supply to raise profits. Limiting supply of healthcare means people die, or suffer from chronic disease, which left unchecked often leads to the emergency room.
Insurance only works with giant risk pools. If millions of people are insured by one company, that creates a market imbalance where the company has most of the power. Then the handful of insurance companies go to trade conventions where they agree on "industry standards" that let them collude to implement ways to raise premiums and copays, and ways to deny coverage after collecting premiums for years. (And private insurers often pretend that each business is its own risk pool, so that they can punish a business that has a sick employee, and raise profits.
Other reasons why health insurance isnt a market good:
Information is scarce.
It is usually connected to your job, so you can't shop around.
There are huge barriers to entry. You need enough money to create a huge risk pool.
If you let them operate nationally, they need to be regulated nationally.
The only system that can work is single payer universal healthcare. Medicare for all is the smartest option.
By the way, why does global corporate mass media let Republicans get away with claiming that Obama Care was passed without debate, when we spent over a year arguing about after Obama's inauguration, Jan 2009, with the bill being passed in March 2010?
Insurance only works with giant risk pools. If millions of people are insured by one company, that creates a market imbalance where the company has most of the power. Then the handful of insurance companies go to trade conventions where they agree on "industry standards" that let them collude to implement ways to raise premiums and copays, and ways to deny coverage after collecting premiums for years. (And private insurers often pretend that each business is its own risk pool, so that they can punish a business that has a sick employee, and raise profits.
Other reasons why health insurance isnt a market good:
Information is scarce.
It is usually connected to your job, so you can't shop around.
There are huge barriers to entry. You need enough money to create a huge risk pool.
If you let them operate nationally, they need to be regulated nationally.
The only system that can work is single payer universal healthcare. Medicare for all is the smartest option.
By the way, why does global corporate mass media let Republicans get away with claiming that Obama Care was passed without debate, when we spent over a year arguing about after Obama's inauguration, Jan 2009, with the bill being passed in March 2010?
2
"How did the party’s leaders put themselves in this position? The short answer is that they began believing their own hype and set out to solve a problem that doesn’t exist."
Making a bigger mess solving problems that don't exist is, in a nutshell, now the Republican way -- not only in healthcare, but in other areas, too. North Carolina is suffering losses in tourism and business because of its legislature's unwillingness to repeal the HB2 law instituted under former governor McCrory (who wouldn't back down from a law protecting the need for people who never minded the presence of others to become suspicious of every stranger in a public restroom). Indianans had to beg Mike Pence to repeal (he merely revised) the Religious Freedom Restoration Act, which legalized businesses discriminating against the LGBT population (because what strikes fear in the heart more than a soon-to-be-married gay couple in search of celebratory baked goods?). Then there are the I.D. card efforts to prevent non-existent voter fraud, calls to repeal clean air and clean water legislation (because a healthy environment is such a nefarious thing), and of course the various initiatives to remedy what appears to be the nation's most serious fake problem -- that the ultra-rich are somehow not wealthy enough.
When a Republican proposes to fix a problem, tell him/her to take the day off.
Making a bigger mess solving problems that don't exist is, in a nutshell, now the Republican way -- not only in healthcare, but in other areas, too. North Carolina is suffering losses in tourism and business because of its legislature's unwillingness to repeal the HB2 law instituted under former governor McCrory (who wouldn't back down from a law protecting the need for people who never minded the presence of others to become suspicious of every stranger in a public restroom). Indianans had to beg Mike Pence to repeal (he merely revised) the Religious Freedom Restoration Act, which legalized businesses discriminating against the LGBT population (because what strikes fear in the heart more than a soon-to-be-married gay couple in search of celebratory baked goods?). Then there are the I.D. card efforts to prevent non-existent voter fraud, calls to repeal clean air and clean water legislation (because a healthy environment is such a nefarious thing), and of course the various initiatives to remedy what appears to be the nation's most serious fake problem -- that the ultra-rich are somehow not wealthy enough.
When a Republican proposes to fix a problem, tell him/her to take the day off.
3
One reason premiums have increased so much in some areas under Obamacare is that Republicans have already sabotaged the law. They revoked payments to insurers to cover underestimates of the increased numbers of sick people who would first obtain insurance under Obamacare. So, they raised premiums, deductibles, and co-pays to compensate. That is not sufficiently emphasized. The uncertainly as to the law's future, created by Republicans, has also motivated insurers to withdraw from the exchanges.
With regard to Republican denial that ordinary people will lose their insurance, people will know that they have lost their insurance when it happens. They will know that their bare bones policies effectively do not cover anything. That will be reality and people will know the politicians lied to them.
With regard to Republican denial that ordinary people will lose their insurance, people will know that they have lost their insurance when it happens. They will know that their bare bones policies effectively do not cover anything. That will be reality and people will know the politicians lied to them.
1
Health care should be considered a right like clean water, police protection, a fire department and civil liberties. It does cost society money, and it saves society money by preventing poverty and ensuring a measure of security for its citizens. At present, the insurance and drug companies are making out like bandits and they have been accustomed and incentivized to expect these profits as their rights. Every advanced nation, and some not so advanced nation on earth has a national health care system, funded by state. The Republicans are going to cut off their nose to spite the face. Of course, the ACA can be improved. Of course it will evolve and change. But repealing and replacing it with a self-serving, version that does not provide health care to the most vulnerable members of society is not an improvement. And what is worse, they know it. And I agree, President Obama did what he could to ensue that it was as bipartisan a process as possible. Again the Republicans cut off their noses, to spite their face - and again they know it.
4
The hypocrisy thickens. In order for the market place to function effectively there must be competition. The buyers must be able to negotiate the price. Of course Congress will not allow the government to negotiate the price medicines, the number of physicians trained in my medical school has increased by 10 since 1972 when I became an Assistant Professor there, and the general public do not have access to good information about costs and the risk they take by avoiding the doctor. The fact insurance companies have just dropped out of some markets and/or raised the price beyond affordability is the clearest indicator that consumers can compete in the health market. If you refuse or are unable to afford the cost of a visit to your doctor, too bad, take an aspirin and go to bed. When their government representatives refuse to pay exorbitant prices, the insurance companies just move elsewhere. There seems to be no pressure to lower the multimillion dollar salaries of Company administrators, instead they reconfigure the market, and continue to make incredible profits. Would somebody please calculate how much my annual healthcare costs would change if there was no middleman, and we had a single payer system that could negotiate prices with hospitals and doctors!
2
Having spent my career working with graduate students in their twenties, I would like to point out that the assumption made by both sides that people in that age group don't "need" health coverage is simply false. People in their twenties are diagnosed with serious diseases, are injured in car wrecks, are hit by gunfire etc. For those without medical coverage, the results for them and their families can be catastrophic. Everyone in the United States needs and deserves quality medical care, period. Will we ever progress to real discussion of a single payer system, or are we doomed to continued regression, as represented by the cynicism of Trumpcare? As President Tweet would say, SAD.
321
Senator Obama supported universal health care, which every sane advanced nation has successfully implemented. It provides better healthcare than either Obamacare or (especially) Trumpcare. Lifespans and "healthspans" are 3 to 5 years longer in the rest of the west, while the countries spend around 10% of GDP on healthcare (the US spends upwards of 18% of GDP per capita for less coverage & poorer results). Desperate to re-introduce bi-partisanship into a dysfunctionally partisan system (thanks for the most part to the GOP), Obama took UHC off the table. In his bill, he tried to have half-a-loaf, with the Public Option or Medicare for All, which would compete in the marketplace with private for-profit existing insurance. The GOP blocked any chance of passing a bill that allowed public insurance to compete with their for-profit insurance company benefactors. Instead, they proposed that the Individual Mandate (a program developed in 1989 by the conservative Heritage Foundation) be substituted. IM would still force all people to buy healthcare from the for-profits, subsidizing those who could not afford their rates with tax-payer money. This was a windfall of taxpayer money to the for-profits. Obama caved and substituted IM for the Public Option & the GOP turned 180 & began denouncing IM as the end of democracy. It's now the part they pretend to hate the most.
Read Mitt Romney's op-ed in USA Today on July 31, 2009 for the GOP pitch for IM in place of the Public Option.
Read Mitt Romney's op-ed in USA Today on July 31, 2009 for the GOP pitch for IM in place of the Public Option.
131
Frank Luntz is a revered Republican propagandist extraordinaire (the man behind the curtain, similar to Lee Atwater) who understands how carefully selected words used repeatedly, relentlessly, and consistently by the Republican party can profoundly alter, sway, and change the beliefs and opinions of an unwitting targeted demographic. Note the specific words used every news cycle by all the Republicans. He understands cognitive science and how to utilize a cognitive science tactic referred to as "word priming."
For example, the word "liberal" had become commonly interpreted and/or associated with elitist, abortion, any faith not Christian, diversity, denial of inalienable human rights, anti-gun, welfare entitlements and so forth. This is one of the main reasons that progressive-not liberal-has become the newspeak of Democrats.
A documentary showed the reliability of this word priming technique. By asking several questions in a row, he could prime the minds of 70% of a large audience to say a specific word to answer his last question. I have used this same series of questions on many people with the same 7 out 10 predictability results.
This priming technique reminds me of the philosopher Wittgenstein's dictum that "the thought is the language." And of course, Goebbels's tactic-repeat a lie often enough and it will become the truth and an established fact to use to influence and shape a significant majority of useful idiots'
minds.
For example, the word "liberal" had become commonly interpreted and/or associated with elitist, abortion, any faith not Christian, diversity, denial of inalienable human rights, anti-gun, welfare entitlements and so forth. This is one of the main reasons that progressive-not liberal-has become the newspeak of Democrats.
A documentary showed the reliability of this word priming technique. By asking several questions in a row, he could prime the minds of 70% of a large audience to say a specific word to answer his last question. I have used this same series of questions on many people with the same 7 out 10 predictability results.
This priming technique reminds me of the philosopher Wittgenstein's dictum that "the thought is the language." And of course, Goebbels's tactic-repeat a lie often enough and it will become the truth and an established fact to use to influence and shape a significant majority of useful idiots'
minds.
263
Such an excellent summary of the legislative history of the ACA. Reading it, I felt by blood pressure rising. Not because of the dastardly lies and obfuscation from the Republicans about the bipartisan nature of Obamacare. But more so about the naivety of my progressive friends and colleagues, constantly berating Obama for a "half-baked" plan that didn't go far enough and didn't even provide a government option. It was this dissatisfaction from those of us on the left that arguably left us in the horrible situation we now face. Luckily, it seems President Obama created a legacy with sufficient substance, combined with a (hopefully) resilient set of Constitutional institutions, that we may yet live to tell the tale of surviving this so-called president.
4
Unfortunately, democratic capitalism has descended into the mire of corporatism. Whether it's the ACA or this so-called replacement nonsense, the truth is the one expenditure that simply fails every time when free-market principles are applied is Health Care. What the pundits and the Republicans will not admit is that a single-payer system that ensures universal coverage for all (as exists in virtually every civilized, free society on Earth) would mean that a set of large corporations known as Health Insurance Companies will no longer be able to make profits. This political abyss will never tolerate the end of a conglomerate that exists like all other corporations for one purpose, to make money.
14
Do I dare ask the question, would this bill pass...if it encompassed health care for everyone, including elected officials?
They deserve to have the same as the rest of Americans.
They deserve to have the same as the rest of Americans.
4
And the latest lie about Obamacare is that the House Republican bill to replace it will reduce spending on health care. All this legislation will do is shift the costs from the federal government to the states. Ironically (or deservedly), it will result in less money flowing from wealthy states and regions within states to the poorer areas, many of which went for Trump. Also, many rural hospitals, clinics and health care providers rely far more on Medicaid than those in cities, so maybe you will be able to choose your doctor under the GOP plan, but your doctor may move away or your local hospital may simply close dues to these cuts.
I suspect that many Trump and GOP voters will soon get "tired of winning.”
I suspect that many Trump and GOP voters will soon get "tired of winning.”
And the latest lie about Obamacare is that it will reduce spending on health care. All this legislation will do is shift the costs from the federal government to the states. Ironically (or deservedly), it will result in less money flowing from wealthy states and regions within states to the poorer areas, many of which went for Trump. Also, many rural hospitals, clinics and health care providers rely far more on Medicaid than those in cities, so maybe you will be able to choose your doctor under the GOP plan, but your doctor may move away or your local hospital may simply close dues to these cuts. I suspect that many Trump and GOP voters will soon get "tired of winning."
4
With every analysis competing for the highest number of people that will LOSE health care it's hard to understand how anyone who campaigned for greater coverage could support this plan. Assuming that health care was ever a goal. At one time the GOP's hatred of Obamacare passed through a phase of "not being good enough" playing with the implication that it didn't cover as many as it should have....another twisted word deceit.
5
What's more is the fact that Republicans who can actually legislate have been pushed out by Tea Party ideologues who specialize solely in opposition. They excel at talking bad of any legislative initiative outside the realm of tax and spending cuts. They have no ideas for how government can improve the United States, refuse to compromise, and are beholden to the ludicrous restraints of their "conservative" ideology. The Republican Party cannot and will not be capable of creating functional legislation until these people are voted out (a prospect I have little hope for).
38
Why do so few articles ever note that previous conservative plans are essentially implemented in the current ACA? The 1989 Herritage Foundation and Obamacare are about as close as a concept and legislation can get, yet it is seldom cited.
27
NO,
the Heritage Foundation plan is MILES from what Barack, Nancy and Harry cooked up for us. The PPACA was so bad that even with a solidly Democratic Congress it STILL took over a year to cram though Congress with less than a 60-vote Senate majority.
Those actually wanting to read what Heritage says about the PPACA or their own ideas can be read on their .org website. I have seen Leftist talkers try to blame Obamacare on everybody BUT them for seven years now, and a lie is still a lie.
Romney did the right thing in one crucial point: in a STATE, not forcing an untried scheme on the entire country from Day One.
Every state with a Dem governor seems to have tried their own version of tax-supported health care experiments, and all have failed.
Vermont works or - Years? - to write up a single-payer plan but could never make it work.
They say that California is now trying a health plan; a state is where such things need to be tried out.
the Heritage Foundation plan is MILES from what Barack, Nancy and Harry cooked up for us. The PPACA was so bad that even with a solidly Democratic Congress it STILL took over a year to cram though Congress with less than a 60-vote Senate majority.
Those actually wanting to read what Heritage says about the PPACA or their own ideas can be read on their .org website. I have seen Leftist talkers try to blame Obamacare on everybody BUT them for seven years now, and a lie is still a lie.
Romney did the right thing in one crucial point: in a STATE, not forcing an untried scheme on the entire country from Day One.
Every state with a Dem governor seems to have tried their own version of tax-supported health care experiments, and all have failed.
Vermont works or - Years? - to write up a single-payer plan but could never make it work.
They say that California is now trying a health plan; a state is where such things need to be tried out.
The republicans relinquished their credibility decades ago- it is only the false equivalence provided by most of the media- to not offend any possible customers- NOT TO PROVIDE FAIRNESS OR CONTEXT - which allows republican narrative viability
22
Thank you for reminding people of this simple truth. I always put it slightly more strongly, that "Obamacare" IS the Republican plan for providing universal health care (well, it's a quote from Romney, describing his version). That's the essential reason for what is otherwise inexplicable: why, while voting to repeal the ACA sixty times, they hadn't been able to think of an alternative. What really puzzles me is why Obama wouldn't say that from the beginning;one cannot do that after a controversy has been created.
17
So...who will pay for those who no longer have insurance and do not receive preventative care, thus ending up in the emergency room when they get really sick (and their care becomes more expensive)....the taxpayers in some way, shape or form. Meanwhile the rich (and Congress) will have great health care and benefit from tax cuts and continue to wear blinders when it comes to the average American. Sad.
27
I wonder how so many other countries have figured out how to provide health care for all their citizens.
27
Given this conservative hatred of requiring people to buy products, in this case health insurance, where's the conservative outrage over laws requiring mandatory automobile insurance?
20
Trump could not have won the election without an awful lot of votes from the 24 million Americans who now stand to lose their health insurance.
I'm hoping that this will be the wake-up call. I just wish it didn't have to come at such a high cost.
On the other hand, I think that up to now we've only seen the tip of the iceberg with respect to the capacity of the President to peddle lies and the willingness of his supporters to swallow them whole.
I'm hoping that this will be the wake-up call. I just wish it didn't have to come at such a high cost.
On the other hand, I think that up to now we've only seen the tip of the iceberg with respect to the capacity of the President to peddle lies and the willingness of his supporters to swallow them whole.
As both a health care provider AND a self-employed person, I have experienced the ACA from both perspectives. I do not qualify for a subsidy so I pay my premiums in full. My $5000 deductible policy went from $340 to $827 in 3 years. (If the GOP has their way, I will pay significantly more, if I decide to remain insured.) But I have also seen so many people get dearly needed medical/mental health care that would have been out of the question prior to the ACA.
Of course the first years of the ACA were destined to bring people like me some financial pain, because all of a sudden the formerly uninsurable with serious medical issues signed up, while the penalties were low enough to keep the young and healthy from doing so. Rather than doing away with the mandate (that works so well for auto insurance), it should be strengthened so that everyone has to contribute. Since in a few years there won't be a surge of the very sick getting insurance for the first time, the market will stabilize and premiums will become more affordable. We'd have a healthier and therefore more productive work force, which will strengthen and grow the economy and the tax payers won't have to pay for emergency room care for the millions of uninsured.
But the GOP are much more concerned about their political (and cruel) ideology than it's ever been about making life more livable for its citizens.
Shame, shame, shame on you all.
Of course the first years of the ACA were destined to bring people like me some financial pain, because all of a sudden the formerly uninsurable with serious medical issues signed up, while the penalties were low enough to keep the young and healthy from doing so. Rather than doing away with the mandate (that works so well for auto insurance), it should be strengthened so that everyone has to contribute. Since in a few years there won't be a surge of the very sick getting insurance for the first time, the market will stabilize and premiums will become more affordable. We'd have a healthier and therefore more productive work force, which will strengthen and grow the economy and the tax payers won't have to pay for emergency room care for the millions of uninsured.
But the GOP are much more concerned about their political (and cruel) ideology than it's ever been about making life more livable for its citizens.
Shame, shame, shame on you all.
54
Oddly enough, my own plan, also not eligible for the ACA subsidy, but which I simply bought on the open market, not through an exchange, started higher than yours and ended up lower. In other words, ACA worked well for me!
2
"Today’s Republican Party has moved so far to the right that it no longer supports any plan that covers the uninsured. Of course, Republican leaders are not willing to say as much, because they know how unpopular that position is."
And because they know that many of their voters fall into that vast swath of currently or soon-to-be uninsured.
And because they know that many of their voters fall into that vast swath of currently or soon-to-be uninsured.
8
If the Republicans want to elect a Democratic Congress, they can do it with this plan. If they have any sense, they will realize that if even a single person loses insurance as a result of their plan, that person will feature in every Democratic campaign ad in 2018.
18
Efforts to provide national health insurance began during the progressive era early in the twentieth century. Conservatives opposed it, because they thought it would transfer wealth from from the people who were prosperous to the middle and working classes. As the cost of health care rose, with the development of new drugs, devices, and therapies, their resistance stiffened.
Now even conservative doctors and hospitals favor national health insurance, because they realize that it will provide them with more patients and fees to cover their ever-growing overhead costs.
Today, the Republican ideology stresses competition and free-markets, but it doesn't accept that the market for health insurance is very different from the markets for most other goods and services that they learned about years ago in Economics 101.
Now even conservative doctors and hospitals favor national health insurance, because they realize that it will provide them with more patients and fees to cover their ever-growing overhead costs.
Today, the Republican ideology stresses competition and free-markets, but it doesn't accept that the market for health insurance is very different from the markets for most other goods and services that they learned about years ago in Economics 101.
19
This constant drift to the right is a profound defect in the republican agenda and has weakened America and even capitalism, the secular god of the right wing.
10
The Original Lie is that healthcare is a right, rather than a privilege.
4
Members of the House and Senate should only receive the exact same health insurance they are trying to push on the rest of us. While they are at it to help save tax dollars they should forgo all their entitlements such as travel expenses, car expenses, "health club" etc. Base on their job performance in areas like infrastructure, education, high speed rail, and bi-parisan cooperation Republicans and Democrats should forgo any benefits for poor job performance.
22
If the Rich had to pay higher taxes to pay for universal healthcare, then the price of healthcare would surely go down.
5
For profit health insurance, in today's world, is an oxymoron. And denial of medical coverage on the basis of cost, is taking an innocent life.
14
The few "fixes" the GOP has offered to reduce healthcare costs like selling across state lines and tort reform, could just as easily be done within the Obamacare framework. But those are just distractions that would have little effect on overall healthcare costs.
4
Lies are politically expedient until it's your time to govern. 77,001 votes would have spared us from this travesty.
16
To simplify existing medical coverages in different countries, Britain has a socialized medical system where hospitals and most doctors are under state control. Canada has system where the insurance is public. Switzerland has something close to Obamacare where there are private players in the health system, but their profit is controlled, similar to utilities. We have had some form of public power for over a hundred years, so applying this concept to the health system is hardly a radical step. We also have an example of the richest country in the world where it is working well, and where it was recently endorsed by Swiss voters over a single payer system. Is there any historic example of something like the Republican plan anywhere working to provide coverage of most of the people?
12
As long as they call it Trumpcare or Donaldcare and it does lethal political damage to Trump and his supporters, I'm for it one hundred percent.
Additional beneficiaries with Obamacare did not add as much cost as expected. Is there data to show that some of the savings was from diversion of care from emergency rooms to doctor's offices?
Republicans have made a holy grail of "deficit reduction" in recent years. They reduce the deficit by some $300 billion over 10 years by denying healthcare to millions of Americans, principally those who now receive it through Medicaid or with major premium support through Obamacare.
But if Republicans were serious about deficit reduction, they would not hand over $800 billion in tax cuts to the richest Americans during the next 10 years.
Time to replace these phony deficit hawks with Representatives and Senators who represent the interests of ALL Americans.
But if Republicans were serious about deficit reduction, they would not hand over $800 billion in tax cuts to the richest Americans during the next 10 years.
Time to replace these phony deficit hawks with Representatives and Senators who represent the interests of ALL Americans.
12
I recall watching a PBS Newshour segment on health care reform during the summer of 2009: Democratic and Republican senators discussed negotiations and possible compromises. Asked for a last word, the Republican said that "we agree on 85 to 90% of this, and we just need to close the gap on that last 10 to 15%." Less than a week later, everyone's favorite Alaska governor started ranting about "death panels," GOP opposition to the Obama Administration went off the deep end, and here we are.
13
Where is your alternative fact that if left with just Obamacare more people would be without AFFORDABLE health care than with this, as yet, unfinished bill?
4
Unfinished?! No, it's finished because it was an absurd nonstarter.
Now is the time to begin fixing ACA by increasing the penalty for not buying insurance and forcing the states to set up their exchanges and accept the Medicaid expansion.
Now is the time to begin fixing ACA by increasing the penalty for not buying insurance and forcing the states to set up their exchanges and accept the Medicaid expansion.
Our system of healthcare in this country is clearly a disaster. It evolved organically over a 100 year period as employers decided to help the workers get decent health care into a system dominated by corporations. The system was not designed to provide health care for everyone. Changing the system from one that provide healthcare to those who have good jobs and can afford it to one that provided healthcare to everyone requires fundamental changes that will be very disruptive to lots of people who like things the way they are. Insurance companies that can effectively 'tax' employees and employers. A huge cottage industry of IT organizations that exist only to support the insurance companies. And even health care professionals who have grown accustomed to being able to name their price on things like a hip replacement with no real market forces limiting them.
The ACA was a good political attempt to solve the problem but we re going to need more.
The ACA was a good political attempt to solve the problem but we re going to need more.
3
Maybe we don't deserve insurance against illness and financial ruin. We're so easily manipulated by politicians and blinded by our own prejudice we can't figure out something most civilized places resolved long ago. On the plus side, we finally elected the embodiment of the only things we truly worship in this country - celebrity and money.
4
Chalk this up to, be careful for whom you vote and vote informed, not emotionally.
11
Looking at this from away, probably the largest flaw is that neither it nor its 'successor' really has anything to do about healthcare. Keeping the insurance companies in the drivers seat as far as costs were concerned (and their profit margins) did little to restrain cost inflation. Unlike car insurance, healthcare insurance is far more likely to be used regularly -- so there is less opportunity for investing to provide the supplemental incomes to cover costs. Effectively it becomes a wealth transfer mechanism. Medicare, from what I have read, is far more effective -- probably why its being attacked as well. Reading about this, I thank the fates that I worked for a company that moved me to Canada -- where there is a decent single payer healthcare system (like most of the developed world). And I can watch the antics from afar, sorry for my friends and family members who are stuck with this nightmare. And no indication that the religious among the legislators will embrace the duty to take care of those less fortunate.
3
Capitalism does not work in the medical care market. Hospitals and mds do not advertise by extolling their low prices. If I am in an auto accident I want the nearest hospital not the cheapest. the public is totally in the dark about what medical care really costs. People are unable to weigh efficacy v price, then insurance adds another layer of cost. Single payer such as Canada's is the way to go, and I don't want to hear about Canadians streaming into the states for "superior medical care."
4
The Republican's so called plan is the best that a phoney and disingenuous "policy expert" like Paul Ryan can come up with.
2
This is a very clear eyed look at the history of the ACA legislation.
However, your end note, "Believing your own alternative facts, however, is usually not so smart." actually has an element of optimism that I don't share.
I'm not so sure that what the GOP in congress actually believe matters.
It's what they can make the rubes in this country believe, and so far their strategy seems to be working very well.
However, your end note, "Believing your own alternative facts, however, is usually not so smart." actually has an element of optimism that I don't share.
I'm not so sure that what the GOP in congress actually believe matters.
It's what they can make the rubes in this country believe, and so far their strategy seems to be working very well.
4
Obamacare could have been substantively better if Obama had not allowed health insurers to kill the public option which would have allowed medicare to sell health insurance on the exchanges. Insurance markets could have had real competition and health insurers would have been forced to provide lower cost, higher quality product.
The bill went too far right in a vain attempt to please everyone or maybe to please the health insurers who have been instrumental in killing it.
The bill went too far right in a vain attempt to please everyone or maybe to please the health insurers who have been instrumental in killing it.
2
What bothers me is that the GOP plan is tantamount to the murder of many & concomitant w/ that I'm deeply disturbed that so many of the GOP actions are just willful destruction of a plethora of important & beneficial government programs for the sake of petty vindictiveness. You can't tell me they don't realize that gutting EPA & the Dept. of Ed & so on are all heinous crimes against the country.
Another example of the increasing Republican version of capitalism imitating fuedalism. We're well on that road now--this plan outlines it perfectly.
1
If we consider the GOP "base" to be blue collar and rural America, it is ironic that the GOP has been honoring its base by sabotaging the ACA and ultimately trying to kill it, yet the GOP base is going to be in trouble with the new plan. Of course, the GOP "base" is not blue collar and rural America, it is the Koch brothers and the obscenely rich who keep GOP congressmen in office with dark money. How can the religious right justify taking health insurance from millions of people?
5
Wonderfully accurate portrayal of the process; however, the conclusion is not borne out by recent history. Republicans have consistently lied, obfuscated, obstructed, and in general pulled every dirty trick in the book to gain power - and it has been working like a charm: since the passing of the ACA in 2010, Americans have handed the R's one electoral victory after another. The worse they behave, the more elections they win.
Until and unless Americans abandon this love affair with magical thinking - the notion that we can have affordable, accessible health care for all without curtailing the runaway profits of the health care industry or shifting more of the cost to billionaires - then we will continue to see this shell game playing out.
And the Republicans have become so adept at spin that they will still manage to convince the American public that if they would just elect more Republicans, things will be perfect.
Until and unless Americans abandon this love affair with magical thinking - the notion that we can have affordable, accessible health care for all without curtailing the runaway profits of the health care industry or shifting more of the cost to billionaires - then we will continue to see this shell game playing out.
And the Republicans have become so adept at spin that they will still manage to convince the American public that if they would just elect more Republicans, things will be perfect.
For 75 years, it was said that Roosevelt's New Deal saved capitalism. By softening the rough edges of the free market capitalism with reforms such as social security and unemployment insurance, FDR may have prevented adoption of much more radical changes.
75 years from today it is unlikely that anyone will think Obama saved market-priced medical care. Rather, he only prolonged it, and that will not be thought of as a good thing. In the developed world, market-priced medical care still exists only in the USA.
The USA is the last holdout with market-priced medical care not only because of any inherent conservative or free market ideology. Rather, as the wealthiest nation that ever existed we are the last ones who can afford it.
The reason that no nation, including the wealthiest can allow markets to set the prices of medical care indefinitely is that demand for medical care is inelastic. Demand for a good or service is inelastic if a percentage increase in price results in a smaller percentage decrease in the quantity demanded.
Basic economics tells us that sellers facing inelastic demand will continuously raise prices until prices reach the elastic portion of the demand curve. Consequently in every developed country in the world, all goods or services with inelastic demand have their prices regulated by government. Medical care in the USA being the only exception..."
http://seekingalpha.com/article/1647632
75 years from today it is unlikely that anyone will think Obama saved market-priced medical care. Rather, he only prolonged it, and that will not be thought of as a good thing. In the developed world, market-priced medical care still exists only in the USA.
The USA is the last holdout with market-priced medical care not only because of any inherent conservative or free market ideology. Rather, as the wealthiest nation that ever existed we are the last ones who can afford it.
The reason that no nation, including the wealthiest can allow markets to set the prices of medical care indefinitely is that demand for medical care is inelastic. Demand for a good or service is inelastic if a percentage increase in price results in a smaller percentage decrease in the quantity demanded.
Basic economics tells us that sellers facing inelastic demand will continuously raise prices until prices reach the elastic portion of the demand curve. Consequently in every developed country in the world, all goods or services with inelastic demand have their prices regulated by government. Medical care in the USA being the only exception..."
http://seekingalpha.com/article/1647632
8
The Republican House leadership “plan” creates an economic disincentive for lower income people to earn more. Current law sets “expanded” Medicaid eligibility, the Obamacare or Affordable Care Act program for lower income people, at 133 percent of “modified adjusted gross income” (MAGI) in most states, 200 percent in NY and MN, and 210 percent in DC. The mechanism in the Republican House leadership bill makes people whose incomes rise ineligible to regain Medicaid coverage should their incomes subsequently drop below those levels. Consider decision-making in a lower income household where a new job is in the offing at an increased income level that would push income above the eligibility threshold. That would push the household off Medicaid and most likely on to the private insurance market where premiums would be vastly higher than under Obamacare. The household would then evaluate the risk of losing income in the future without the ability to regain Medicaid coverage. Through this mechanism, the Republican House leadership plan creates a disincentive for lower income people to seek increased income. If a Democrat proposed such a policy the Republicans would attack it as “job-killing,” “class warfare,” or anti-capitalist. Mostly it is just wrong, like so much else in this proposal that will raise insurance costs for the people in the lower income levels while providing financial benefit to those at the higher end.
4
I have a basic question about health insurance pools. Why are health insurance companies allowed through regulation (presumably) to divide up their insurance subscribers into separate pools? We don't see this with car insurance or other types of insurance. If insurance companies were forced to put all of their subscribers into one universal pool, wouldn't that even out the younger, older, employed, unemployed, retired early, healthier, and sicker folks who subscribe to that insurance company's policies? If the answer from insurance companies is administrative costs, then the companies and our policy makers need to decide on a new process for offering health insurance under one umbrella pool per insurance company. If Americans under 65 have to live with private health insurance then the health insurance industry must be reined in.
1
A friend of mine has a saying that I believe is apt. Don't feed me a cowpie and call it a muffin.
2
why don't we just call it the Unaffordable Care Act (UCA)
2
"Tom Cotton, the Republican senator from Arkansas, has said the bill is so bad that it would “put the House majority at risk next year.”
Thanks Tom for explaining the only thing that is of any real concern to the Repub in congress - staying in power. A solution to health coverage/care is just an annoyance and a distraction from their real plans for selling off the resources of this country to business interest.
Thanks Tom for explaining the only thing that is of any real concern to the Repub in congress - staying in power. A solution to health coverage/care is just an annoyance and a distraction from their real plans for selling off the resources of this country to business interest.
3
The old system was not working either. Having the ER as your primary care provider disrupted insurance costs. Moving to this GOP replacement will only increase disruption and everyone will pay, one way or another. Another being opioid addition, suffering and death. How much of the opioid epidemic is a by product of poor access to pain management and legitimate drug cost?
This article nails the essence of politics in this country: The Republicans go to the right and the Democrats, so eager to make a deal and "look reasonable" get pulled along - albeit still to the left of the R's.
So much so that Dwight Eisenhower's 1956 platform was to the left of Bernie Sanders
So much so that Dwight Eisenhower's 1956 platform was to the left of Bernie Sanders
2
Obamacare helped more people get coverage, but it is deeply flawed. We need medicare for all, single payer, efficient, low overhead costs. Come on America, let's do this sooner rather than later. The current mess in Washington is so painful, our country is in big trouble.
2
The only "death panel" the republicans seem to worry about is the one that this bill represents for their party.
2
Republican obstruction and lies over the last eight years have brought them to this pivotal moment. So far, media and Democrat timidity and hypocrisy have allowed the GOP and 45 to play this game with our healthcare system. What happens over the next few weeks will give all of us a pretty good idea what our country's future will look like. If the GOP Congress goes ahead and passes this bill and 45 signs it into law, we will be looking at a bleaker future for most Americans. If someone in the Republican Party or the administration can put on the brakes on this runaway ambulance, then there may be a chance to get some kind of healthcare fix that will actually help more Americans than it hurts. I am hoping for the second scenario, but I realize that the first is much more likely.
partisan, socialistic big-government takeover of health care - a good idea.
1
The key ingredient for a successful private healthcare insurance plan that guarantees insurance despite pre-existing medical conditions is the mandate clause that compels universal coverage. The Republicans actually came a p we th this idea originally as described in the article. When the ACA was being passed Republicans guttted this part but reducing the penalty to an amount that was only a tiny fraction of the cost of insurance. Because of this many young people have merely paid the mandate penalty knowing that if they were in need of insurance in the future they could always get it. This has led to a huge Theresa risk pool of insured driving up costs. If the mandate fines were higher and the proceeds were used to fund uninsured emergency care and preventitive care in underserved areas the system would improve overall healthcare and would be closer to self supporting. Additionally the insured pool would be healthier and individual costs would drop.
1
One quick and fair way to untie this complication: take away the taxpayer funded super-generous healthcare that members of congress and their families enjoy. Make them go out into the real world and purchase their own insurance!
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Never, ever will happen. This gold-plated benefit and all the other perks is why we now have a permanent group of elected congress people, rather than a house of reps filled by constantly changing members, as the founders envisioned.It is why they run for reelection the minute the polls have closed on the last. It is why we are an oligarchy, run by corporations.
This does not quite work because members of Congress are being paid enough that paying for their healthcare, while painful, is not a life and death kind of thing. Asking them for $12,000 is not the same as asking someone who is unemployed or making minimum wage to pay $12,000 or even a minimally adjusted smaller number. Members could use the tax breaks as part of a bigger picture. A lot of Americans don't have a bigger picture. Applecare, the WA state plan associated with the ACA, works well for my son. I'd like to keep it and I voted that way last year.
If i ever see frank luntz as a consultant for charlie rose and cbs morning news, it'll be the last time i ever watch that network....
the only people happy after this republican "fix" will be the debt collectors
the only people happy after this republican "fix" will be the debt collectors
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Trumpcare is Bummercare, it's a huge tax cut for the rich. The ACA is a vehicle for insurance companies to sell healthcare insurance. To solve rising cost of healthcare in this country we should be focusing on the cost of healthcare, first would be to get rid of the for profit insurance companies would be a start. The focusing on the cost of care. Right now our nation seems to be stuck on the cost of insurance and until we get past that, this issue isn't going away.
3
Hey, with all the dying thanks to lying-Ryan, Rubio, and McConnell there's going to be a lot more parking places and commute times will be shortened with so many dead drivers, no more long waits at the doctor's office with so many dead patients, and slum lords trying to get their start like Trump will make you a deal you cannot refuse on a NYC flophouse.
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Every American should read and reflect on this piece.
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Historically "markets" have been places of intrigue and mayhem, double- and triple-crossings, brutal profit-takings and pathetic loss-sufferings. This has been so for thousands of years, from Rome through Arabia to China. As such it is hard for me to relate to the lament about "artificially" distorting markets. The market itself is a grotesque distortion. Closer to home than Rome and in our time, the genius presiding over us now managed to lose 900 million dollars -- by running a gambling house. What did the undistorted market do? It collected, over the ensuing years, nickels and dimes (and a few larger bills, too) from the rest of us -- until the lost genius was made whole to the last dime
1
The "problem" with our healthcare is the the same one that runs as a thread through our whole country...capitalist greed trumping (excuse the pun) national democratic values. The good part of post-WWII America was its industrial boom. People had cars, homes, could support a family on one income if they chose to do so. We were a wealthy country. I am not saying return to the "good ol' days with the civil horrors of those times. But today's top CEO-to-worker pay ratio for the 168 companies included a recent report stands at about about 70-to-1, some CEOs making more than 300 times. In the 50s it was 20-to-one. Which companies are the richest in the US? Insurance companies are pretty high up there and the 5 highest paid CEOs get between $10 to $17.5 million. Not-for-profit hospitals aren't much better. According to the LA Times, the GOP's new plan has a little perk for them as well:It does so by removing the ACA’s limit on corporate tax deductions for executive pay. The cost to us for this: well in excess of $70 million a year. According to a respected study that would have been enough that year to buy dental insurance for 262,000 Americans, or pay the silver plan deductibles for 28,000. Chew on that, GOP. How much do you depend on Ins. Co. funds for your re-election again?
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What happens when someone writes an article that explains in simple, understandable terms what is going on with Obamacare and all the 8 years of efforts to repeal it?
It becomes an incredible piece of work that will sit at the center of all the back and forth arguments and itself will become the "bible" for all the organizations and individuals opposing what the Repulicans plan to do about Obamacare, namely, nothing.
It becomes an incredible piece of work that will sit at the center of all the back and forth arguments and itself will become the "bible" for all the organizations and individuals opposing what the Repulicans plan to do about Obamacare, namely, nothing.
When one party, in this case, the Republican party refuses to participate and then claims it was pushed through on a partisan basis is the big lie. When will the American people wake up to the fact that the Republicans are a scourge on American society?
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Quick answer to your question: Most likely never.
You are at least explaining why "Health Care" is partisan. The dirty secret is that Health care is too expensive and health care insurance has become one of the most expensive parts of our personal and business budgets. In any given day most people in the country don't need health care but they need insurance. The Holy Grail of public policy would be to develop a plan that would cover the need for health care, but eliminate excess costs and make the cost appropriate to the benefit accrued. Our society is used to distorting the cost vs. benefit of any particular item. So we should be trying to figure out how to do as good a job as most other industrialized nations, not squabbling about who gets credit. And by the way, don't pay attention to that Ryan guy in the corner he has no idea what he talking about.
Since everyone on the far right has stopped being nice I will too!!! We are not talking about "a Republican Party." We are talking about "Radical Interrupters" bent on creating an America that is alien to the majority of its citizens. The destruction of health care is but one step toward a nation only the super rich want and are willing to pay their so-called Republicans to create.
The mistake of the Democratic Party and the mis-understanding of the American people caught in the middle of the fog of mind games being played on them is a toxic danger to the Constitution.
All of those willing to let the people suffer so the rich can become even richer are the equivalent of ISIS fighters in the streets of a nation on the brink of failure.
The mistake of the Democratic Party and the mis-understanding of the American people caught in the middle of the fog of mind games being played on them is a toxic danger to the Constitution.
All of those willing to let the people suffer so the rich can become even richer are the equivalent of ISIS fighters in the streets of a nation on the brink of failure.
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Forgetting about the merits or lack of them in the GOP so-called health plan, how can the Trumpites not see that taking away guaranteed health care from millions of middle and lower middle class voters whose expectations of better, cheaper coverage were based on Trump's lies, will not backfire at the ballot box or before?
Do the Ryans, McConnells and even Trump really believe that the Spicer damage control and the Kelly Anne Conway alternative facts bluster will get them by when people are dying and being financially ruined?
Spicer and Conway: there is no spin good enough to save a dying child who can't get medical care or prevent a suicide from a father facing economic disaster.
Do the Ryans, McConnells and even Trump really believe that the Spicer damage control and the Kelly Anne Conway alternative facts bluster will get them by when people are dying and being financially ruined?
Spicer and Conway: there is no spin good enough to save a dying child who can't get medical care or prevent a suicide from a father facing economic disaster.
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I think you are wrong Prosenwald. Support for trump and republicans is not going to diminish. Trump and more broadly GOP support comes in part from the very wealthy donor class who is looking for tax breaks-- it is their ONLY driver. They will support anything, anybody who supports this quest. These are not the Rockefeller or the Ford dynasties of the past, who cared for the greater good. Another part of his support comes from single issue voters who will not step off of guns, abortion, school prayer, and gay marriage long enough to see the big picture, assuming they are capable of doing so. The loudest group is the folks who tipped the election. They are too buzzed out by their addiction to Fox, Briebart, Rush,and what they read on social media to come to any grips with reality. As we slide further into third world status, I personally hold these 3 groups-- along with those they elect-- responsible for our national decline. But when they finally see (and feel) our further decline, they will blame it on liberal elites like me, and the democratic party in the aggregate. And their propaganda machine(s) will reinforce this nonsense. Game over, USA.
Why not require members of Congress to set their health care coverage equal to the proportion of coverage of the entire population? If, say, 70% have good coverage, 70% of Congress also would. Another 20%, perhaps, would have lousy coverage, and 10% would have none.
The "public option" is the only reasonable solution to the health care mess the Republicans have created over the last 8 years. Obamacare has been a limited success in spite of their relentless efforts to sabotage it. It still has some problems that could be fixed with simple solutions but it is not going to happen because of the name on the law and the resources that has been invested in it's destruction.
If Trump were to provide the "public option" he could repeal Obamacare in total and replace it with Trumpcare or allow the public to by into Medicaid/ Medicare and still allow for open market competition with private insures and allow for private insures to work with government insurance with supplemental insurance.
If Trump were to provide the "public option" he could repeal Obamacare in total and replace it with Trumpcare or allow the public to by into Medicaid/ Medicare and still allow for open market competition with private insures and allow for private insures to work with government insurance with supplemental insurance.
1
Many Trump supporters say "give him a chance" and I can already hear Republican Congress people, like T. Price, saying "it will cover more people, ignore CBO coverage figures (except cost) and give it a chance." Well, I feel in both cases that's as misguided as saying "he hasn't shot anyone, give him a chance" in response to a gun-wielding person in a crowd. Giving Trump or Trumpcare a chance will likely lead to obvious disasters, and we should not give them a chance.
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The great lie by Republicans that president Obama and the Democrats "rammed Obamacare down our throats" was always cowardly cover for politically craven Republicans. Any reasonable observer could see that Republicans refused to engage in the difficult work of improving the U.S. health care delivery system. The unexpected election of Donald Trump, a buffoon who declared that Republicans would repeal the ACA and replace it with "something really terrific" that would cover everybody, has totally exposed Republicans as the empty, vapid ideologues that they are. I find that to be extremely amusing, apart from the serious issues involved.
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Excellent overview! It seems that most GOP voters have poor memories about real facts but seem to wax nostalgic about "the way Glenn Miller played songs that made the Hit Parade.."
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Leonhardt: "McConnell, the Senate leader, persuaded his colleagues that they could make Obama look bad by denying him bipartisan cover."
McConnell is a major reason our government has not been working. He has placed the nation in peril by his partisanship and disregarded of the public/common good: "A political society endures when it seeks, as a vocation, to satisfy common needs by stimulating the growth of all its members, especially those in situations of greater vulnerability or risk" (address of Pope Francis to Congress).
McConnell is a major reason our government has not been working. He has placed the nation in peril by his partisanship and disregarded of the public/common good: "A political society endures when it seeks, as a vocation, to satisfy common needs by stimulating the growth of all its members, especially those in situations of greater vulnerability or risk" (address of Pope Francis to Congress).
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As bad as republican obstruction and lying has been about the ACA, it was aided greatly by democrat's cowardly refusal in 2010-2012 to support their own bill. Can you blame voters for being confused when the folks that passed the bill won't even support it? Also, when is the last time a democrat reminded us that the ACA was a conservative creation to begin with? As bad as the republicans are, you can always count on democrat's passive aggressive politicking to also get in the way of progress.
The GOP must now reap the bitter harvest from the callous seeds they have sown for the last 8 years. They just can't acknolwedge that healthcare is a right and not a privilege. No one in our society should be cursed to suffer without help through accidents, whether genetic or those incurred via daily life.
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It's quite frustrating that the leader of the free world, at least as of 2016, would have the worst performing health record on the planet for developed countries. What do republicans think when they see higher costs and lower performance? How is that evangelicals could have such disdain for the poor and less fortunate? I always thought that Jesus' message was to care for those who have not, not that the rich should horde and the sick should simply be allowed to die.
1
Senator Cotton is on the mark when he says passing this bill would “put the House majority at risk next year.” A big part of the reason is that some of the people this would hurt are those who were the swing voters for President Trump in the 2016 election. Here is Wisconsin, the state President Trump won with the narrowest margin, there was a direct correlation between ACA enrollment and Trump support-- the counties President Trump won were disproportionately those with the most ACA users. These were the disaffected middle class whites who opted for Trump in the hope he could improve their lot. When you were standing in the crowd at the county fairgrounds to hear candidate Trump bellow "We're going to get rid of Obamacare" it sounded good. But ironically, surveys have shown than many people didn't even realize that "Obamacare" was the same thing as the ACA that was providing them with decent health insurance. So when these people find their health insurance yanked from under them, this will put the Republican leadership in a new light.
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SIngle payer system, please. Within two years all Americans--whether from San Francisco or Iowa--will have accepted it as a part of our landscape, in the same way that Social Security and Medicare are. It will be a non-issue (except to some very rich people, who will have to lose a teensy-weensy proportion of their ridiculous wealth, maybe make do with four homes instead of five. They'll get over it, though.)
I am from the (relatively) sane UK, and grew up with the National Health System. I cannot sing its praises enough. When my mother (who still lives there) got breast cancer, she was treated immediately (she said she felt treated like royalty) in top-notch facilities, and start to finish she didn't pay a single penny--not even for medication. All of her life, she and my father had paid small sums out of their paychecks to the NHS. Now, when she needed it, the NHS was there for her. The last thing people need when they are sick is to worry about financing their medical treatment. What the blazes is wrong with Americans that they can't see the superiority of this system?
I am from the (relatively) sane UK, and grew up with the National Health System. I cannot sing its praises enough. When my mother (who still lives there) got breast cancer, she was treated immediately (she said she felt treated like royalty) in top-notch facilities, and start to finish she didn't pay a single penny--not even for medication. All of her life, she and my father had paid small sums out of their paychecks to the NHS. Now, when she needed it, the NHS was there for her. The last thing people need when they are sick is to worry about financing their medical treatment. What the blazes is wrong with Americans that they can't see the superiority of this system?
2
Excellent synopsis and analysis of the current situation. This what happens when the party of no is unmasked as the party of nothing. Ryan and his ilk are believe giving those that have the least is the same as giving them freedom.
2
"Alas, Paul Ryan, Mitch McConnell and Donald Trump are not trying to fix that problem. They’re trying to fix a fictional one: saving America from a partisan, socialistic big-government takeover of health care."
Well, who knows what Trump is up to - he's both stumping for Ryan and pitching something different.
But Ryan-McConnell and their GOO machine aren't trying to "save America". They're just trying to get a tax cut through Congress for their sponsors. That involves an ad campaign to keep their voters bamboozled, but like any ad campaign, it's a pitch to sell product, nothing more. Don't believe they think "It's the real thing!"
Well, who knows what Trump is up to - he's both stumping for Ryan and pitching something different.
But Ryan-McConnell and their GOO machine aren't trying to "save America". They're just trying to get a tax cut through Congress for their sponsors. That involves an ad campaign to keep their voters bamboozled, but like any ad campaign, it's a pitch to sell product, nothing more. Don't believe they think "It's the real thing!"
2
The beauty of this situation is that the GOP is authoring their own demise. The party of the few is not competent, nor can be trusted to govern the many. After hearing heart rending stories of the epidemic of heartland opioid overdoses they come up with this. No jobs or healthcare for their gullible base (let alone the rest of us!). The true intent of Trumpcare is the most important focus NOT the problems of so called "ObamaCare." Market forces can be remedied. Delivery systems can be improved. But, the patient must not be allowed to die on the operating table while the surgeons pretend they know what they're doing.
"On the other hand, if Republicans fail to pass their own bill, they’ll look weak and incompetent"
But Republicans ARE weak and incompetent - and this administration lies above all others... after seven years of saying they had something better, it was exposed that they never had anything. The only thing Republicans are good at is giving high-end tax cuts.
But Republicans ARE weak and incompetent - and this administration lies above all others... after seven years of saying they had something better, it was exposed that they never had anything. The only thing Republicans are good at is giving high-end tax cuts.
1
To quote Ali Velshi, a Kenyan-born Canadian business journalist and TV commentator of Indian descent, who knows more about economics than Paul Ryan, Tom Price and all the other congressional Republicans combined: "There is not a single market-based health care system that works on this planet or any in the immediate vicinity." Thus every other advanced economy on this earth has some form of a single-payer system. It is as simple as that. So every market-based plan the Republicans come up with is bound to fail, which will eventually penetrate the thickest skulls of their voters and consign their party to the dustbin of history.
The biggest problem with Obamas version is it leaves right leaning states the option of obstructing federal money so their own poor and working poor constituents are not given the Medicaid expansion. They'd rather leave their own state residents, those that are underserved and the working poor with no healthcare. Portability between states as a result is poor AND like in Washington state adjacent states will send their uninsured to lifesaving trauma care and then REFUSE
to allow Washington state to return the trauma patient once their life has been saved, why? Because their state has left them uninsured! Effectively making those in states with expanded Medicaid to foot the bill for republican obstructionists in red states. No wonder people in those states feel Obamacare is broken!
People move around and seek specialty care like cancer treatments for example, in states that have more resources at times. This is why in this 34 year healthcare workers opinion
States that obstruct should at least have to penalized if they choose to obstruct so that adjacent states that do expand Medicaid don't have to pay for residents of states that don't
to allow Washington state to return the trauma patient once their life has been saved, why? Because their state has left them uninsured! Effectively making those in states with expanded Medicaid to foot the bill for republican obstructionists in red states. No wonder people in those states feel Obamacare is broken!
People move around and seek specialty care like cancer treatments for example, in states that have more resources at times. This is why in this 34 year healthcare workers opinion
States that obstruct should at least have to penalized if they choose to obstruct so that adjacent states that do expand Medicaid don't have to pay for residents of states that don't
Hey, Paul Ryan and your cronies: I want a big government takeover of paying for healthcare. That is not the same as the government delivering the healthcare itself. This is the difference between Medicare and the V.A. Thankfully, I will be on Medicare in less than three years, unless the Republicans destroy that too. If Medicare is good enough for older Americans, why isn't it good enough for all of us?
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I would feel better about socialized healthcare if government could adequately address the abuses we see with all social-welfare programs. Since LBJ started the War on Poverty in the 60s, poverty has gotten worse.
The reason, inertia, or lack thereof. A body at rest tends to stay at rest. My wife and I have worked hard for everything we have in life, and have not taken anything for granted. We represent a significant part of the population that doesn't want to have to pay for another's lack of inertia.
Help the truly needy, indeed - and for those who are truly in need and can't ever care for themselves, we should help them for as long as they live.
But track the recipients of social-welfare and get them to a point of self-selected sufficiency as soon as possible. That's what most people who work and pay taxes are angry about.
Using the term "Welfare Queen" is certainly insulting and politically incorrect. But c'mon, everyone understands what it means, inside or outside racial context.
The reason, inertia, or lack thereof. A body at rest tends to stay at rest. My wife and I have worked hard for everything we have in life, and have not taken anything for granted. We represent a significant part of the population that doesn't want to have to pay for another's lack of inertia.
Help the truly needy, indeed - and for those who are truly in need and can't ever care for themselves, we should help them for as long as they live.
But track the recipients of social-welfare and get them to a point of self-selected sufficiency as soon as possible. That's what most people who work and pay taxes are angry about.
Using the term "Welfare Queen" is certainly insulting and politically incorrect. But c'mon, everyone understands what it means, inside or outside racial context.
1
Who told you poverty is getting worse? Fox News?
I wish the history run-through of universal government-provided insurance was more inclusive of other efforts that were shot down (i.e. Nixon's who's plan was scuttled by Ted Kennedy). I think each party has wanted the glory all for itself and hasn't wanted to share the triumphs (and the responsibility of problems) with the other party.
But I think if Nixon's attempt was included here, the punchline about Obamacare being the "ultimate troll" for Republican health reform wouldn't have been as strong.
But I think if Nixon's attempt was included here, the punchline about Obamacare being the "ultimate troll" for Republican health reform wouldn't have been as strong.
1
Thank you for this analysis. I wish someone could explain as directly WHY the Republican party has taken such hard stances on the right. Do its leaders really want to live in a country where so many people, including their own constituents, suffer under dire life circumstances like a lack of health insurance, lack of opportunity, lack of education? What's the endgame here? Does the GOP actually want to return to what FDR described as "one-third of a nation ill-housed, ill-clad, ill-nourished"? Why?
Subjectively picking and choosing a few ideas from "Republican" sources from the past does not make a bill bipartisan. You actually need to obtain votes from the opposition. When you truly try to govern from the middle, you naturally pick up support from the opposition, because the voters in swing districts and states demand that their representatives support the legislation. Obamacare, on the other hand, was so unpopular, so out-of-the-mainstream, the Democrats lost Ted Kennedy's senate seat over the issue, but they forced it through using reconciliation. The Republicans did not even whip the vote. President Obama, on the other hand, had to threaten, cojole, browbeat, and bribe Democrats to stay on board, and he still lost some. When you can't hold on to all of your own party, even after extremely whipping the vote, your proposal is not a compromise.
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Your comment fails to treat goose and gander the same. Everything you say about Obama is true about McConnell. The difference is that Obama represented the majority, as Democrats did and still do, and McConnell represented and represents a minority viciously clinging to power through gerrymandering and other antidemocratic structures.
And they're lying still. The constant refrain, which I'm sure they've ordered spokespeople and pols to say, is that "Obamacare is collapsing."
I've also noticed they've picked up Hillary Clinton's mantra about Obamacare and are already saying that RyanTrumpDon'tCare should be passed and then tweaked and improved.
These people lie to us the way we all breathe. They insult our intelligence - as they reach out to those lacking the intelligence to realize it's all bunk, or so full of irrational hatred for anything Democratic/Liberal/Clinton/Obama that they are willing to sink the ship rather than give up that self-wounding rage.
So ironic that it's conservatives and Republicans always saying that it's Democrats who "hate America", "want to destroy America" and/or "have destroyed America."
All I see is Republicans caring not a whit about 99% of the population and caring only about money and the monied.
I've also noticed they've picked up Hillary Clinton's mantra about Obamacare and are already saying that RyanTrumpDon'tCare should be passed and then tweaked and improved.
These people lie to us the way we all breathe. They insult our intelligence - as they reach out to those lacking the intelligence to realize it's all bunk, or so full of irrational hatred for anything Democratic/Liberal/Clinton/Obama that they are willing to sink the ship rather than give up that self-wounding rage.
So ironic that it's conservatives and Republicans always saying that it's Democrats who "hate America", "want to destroy America" and/or "have destroyed America."
All I see is Republicans caring not a whit about 99% of the population and caring only about money and the monied.
The medical insurance fight shows why offering any compromise to Republicans to gain their support is a fool's errand. President Obama did not learn that lesson, and his presidency was flawed by his unwillingness to take the Republicans on. He adopted a basically Republican plan, Romney's, rather than a single payer or even a government option that Democrats would have preferred. Thank you David Leonhardt for pointing that out.
You can't fix a mess without getting dirty, and you still may not fix it.
The simple solution is Medicare for all. Then let the government regulate fees, drug prices, and access. Allow private healthcare add on -if desired and paid by the patient.
To make it politically feasible have deductibles, taxes, and incentives. 60% of us have some form of government health care now. Just expand it to all. Remove the burden of health payments from our businesses.
The simple solution is Medicare for all. Then let the government regulate fees, drug prices, and access. Allow private healthcare add on -if desired and paid by the patient.
To make it politically feasible have deductibles, taxes, and incentives. 60% of us have some form of government health care now. Just expand it to all. Remove the burden of health payments from our businesses.
1
I am so grateful to see this column. So many people have no recollection of actual history. First, there are those who believe the Democrats are useless because they didn't "just pass single payer." These are folks who must be too young to remember Ted Kennedy's eternal fight for universal single payer coverage. That was his life's mission, but the best he could do was see RomneyCare passed in Massachusetts. He didn't live to see the ACA.
Then, there are the believers of Paul Ryan's re-writing of history, where he brainwashes everyone into believing the Democrats never wanted their "ideas." RomneyCare, what the ACA is based on, is a Republican plan. Romney was and still is a Republican, last time I checked. No, they say, we had all these other great ideas the Democrats wouldn't listen to. What ideas could those possibly be? After promising to have ObamaCare repealed on "day one" there's was no plan to be seen. Did he think no one would notice? Infighting and recriminations ensue. Now they are proposing something I see as akin to NoCare.
Yes, those still reading, Lyndon Johnson fought for Medicare, which was predicted to destroy capitalism. You folks screaming "don't let the government take my Medicare away" have Democrats to thank for that.
We've lost our way. I wish Ted Kennedy was still here to make a speech and straighten us all out. We're on our own now, and we should start by not allowing ourselves to be lied to.
Then, there are the believers of Paul Ryan's re-writing of history, where he brainwashes everyone into believing the Democrats never wanted their "ideas." RomneyCare, what the ACA is based on, is a Republican plan. Romney was and still is a Republican, last time I checked. No, they say, we had all these other great ideas the Democrats wouldn't listen to. What ideas could those possibly be? After promising to have ObamaCare repealed on "day one" there's was no plan to be seen. Did he think no one would notice? Infighting and recriminations ensue. Now they are proposing something I see as akin to NoCare.
Yes, those still reading, Lyndon Johnson fought for Medicare, which was predicted to destroy capitalism. You folks screaming "don't let the government take my Medicare away" have Democrats to thank for that.
We've lost our way. I wish Ted Kennedy was still here to make a speech and straighten us all out. We're on our own now, and we should start by not allowing ourselves to be lied to.
2
Medicare is next ...
Republicans attempt to do away with the ACA is primarily about removing
the Medicare tax from capital gains income (1% never before had to pay
their fair share of Medicare tax on capital gains income).
That Medicare tax on capital gains income helped ACA extend Medicare another 11 yrs.
Repealing ACA sets Medicare back .... 11 yrs again.
Then a weakened Medicare is the next Domino the Republicans will want to
topple (ie., state vouchers).
Republicans attempt to do away with the ACA is primarily about removing
the Medicare tax from capital gains income (1% never before had to pay
their fair share of Medicare tax on capital gains income).
That Medicare tax on capital gains income helped ACA extend Medicare another 11 yrs.
Repealing ACA sets Medicare back .... 11 yrs again.
Then a weakened Medicare is the next Domino the Republicans will want to
topple (ie., state vouchers).
1
Obamacare brought health care to countless uninsured Americans. But the fact remains, health care in America is the most expensive in any civilized or under-civilized nation on the planet. Drug companies charge whatever (Big Pharma dictates, lobbies our Congress people), doctors and dentists are the highest paid individuals outside of CEOS and entertainment and sports industry and Research & development plus marketing of drugs are expensive occupations that put the burden squarely on consumers and taxpayers.
Health care in America is just not fair. Instead of learning from Commonwealth nations like NZ and Australia, the Scandinavian countries...American politicians cluelessly aid and collude in selling the MOST expensive health care delivery system in the WORLD.
Health care in America is just not fair. Instead of learning from Commonwealth nations like NZ and Australia, the Scandinavian countries...American politicians cluelessly aid and collude in selling the MOST expensive health care delivery system in the WORLD.
1
Heckuva job, Paulie!
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It's doubtful that Republican Party leaders "began believing their own hype" about Obamacare. They've just been lying - see the article today about fact checking Trump's lies about Obamacare. And they are now lying to sell their American Health Care Act (AHCA). Since Monday Paul Ryan has said repeatedly that it is more choice and competition that will lower costs under the AHCA. And after the CBO report came out yesterday he minimized the fact that 24 million will lose coverage and again lied about why overall average premiums will decrease 10% after 2020. Buried in the CBO report is the truthful explanation.
After 2020 the premium and out-of-pocket cost sharing subsidies of Obamacare will be terminated by the AHCA, which is conveniently after the 2018 congressional election. The premiums and out-of-pockets of older adults earning less than 400% of the Federal Poverty Limit (FPL) will skyrocket. They will drop coverage. Since their premiums are much higher than those of the remaining enrollees, the overall average premium will drop 10%. That is the reason average premiums will drop, not because increased choice and competition of the AHCA will result in lower costs. That is a lie.
Note that CBO illustrated in Table 4 that a 64 year old earning 175% of the FPL would pay $1,700 per year in premium under Obamacare but would pay $14,600 per year in premium under AHCA. Plus, they will pay much more in deductibles & co-insurance. That is why so many will drop coverage
After 2020 the premium and out-of-pocket cost sharing subsidies of Obamacare will be terminated by the AHCA, which is conveniently after the 2018 congressional election. The premiums and out-of-pockets of older adults earning less than 400% of the Federal Poverty Limit (FPL) will skyrocket. They will drop coverage. Since their premiums are much higher than those of the remaining enrollees, the overall average premium will drop 10%. That is the reason average premiums will drop, not because increased choice and competition of the AHCA will result in lower costs. That is a lie.
Note that CBO illustrated in Table 4 that a 64 year old earning 175% of the FPL would pay $1,700 per year in premium under Obamacare but would pay $14,600 per year in premium under AHCA. Plus, they will pay much more in deductibles & co-insurance. That is why so many will drop coverage
The real problem is the uninformed American voter. When you have the working poor voting Republican simply because they believe Obama was going to take away their guns you essentially have people who vote against their own best interests. The Republicans count on ignorance to win votes and the current president knows that his supporters would believe him if he said the moon was made out of green cheese. An intelligent, well-informed, well-educated electorate would choose leaders who champion the best interests of the nation and it's people. Unfortunately, our educational system has failed miserably.
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This also reveals how little Republicans believe in democracy and in the basic principles of the Enlightenment.
I've seen good decisionmaking in the area of health care policy, and I've seen bad. This current approach -- this is exactly how not to make policy.
So: Have a handful of people write the bill, take no input from vested interests, keep it secret, spring it on your fellow Congressmen, ram it through committees in the minimum legal time, and don't wait for the CBO (or any other Federal entity, as far as I can tell) to quantify any aspect of it.
What do you really expect to happen? Do you really think that a handful of inexperienced ideologues are just so smart that they, and they alone, will come up with some brilliant solution?
When I worked on the staff of a legislative branch agency charged with making health care policy, we a) made sure that all the vested interests had a seat at the table, b) had open public meetings, c) had competent staff quantify the proposals, d) sought public input, and e) took considerable time before making recommendations for change.
You would be surprised what you can learn from people who disagree with you. Often, it's more than you learn from those with whom you agree.
My suggestion is that the Republicans study the process used for successful health care bills in the past, and emulate that. And abandon their current ill-thought-through approach.
I've seen good decisionmaking in the area of health care policy, and I've seen bad. This current approach -- this is exactly how not to make policy.
So: Have a handful of people write the bill, take no input from vested interests, keep it secret, spring it on your fellow Congressmen, ram it through committees in the minimum legal time, and don't wait for the CBO (or any other Federal entity, as far as I can tell) to quantify any aspect of it.
What do you really expect to happen? Do you really think that a handful of inexperienced ideologues are just so smart that they, and they alone, will come up with some brilliant solution?
When I worked on the staff of a legislative branch agency charged with making health care policy, we a) made sure that all the vested interests had a seat at the table, b) had open public meetings, c) had competent staff quantify the proposals, d) sought public input, and e) took considerable time before making recommendations for change.
You would be surprised what you can learn from people who disagree with you. Often, it's more than you learn from those with whom you agree.
My suggestion is that the Republicans study the process used for successful health care bills in the past, and emulate that. And abandon their current ill-thought-through approach.
1
The conservative Heritage Foundation proposed the individual mandate, subsidies for the poor, and Medicaid reform in the late 1980's. They also proposed taxing as income the premiums paid on behalf of workers by employers, to pay for the subsidies.
Republicans aren't a rational party anymore; they are motivated by an angry base that doesn't have the education to immunize them from the fake news virus.
Republicans aren't a rational party anymore; they are motivated by an angry base that doesn't have the education to immunize them from the fake news virus.
I had a chance to hear former Congressman Henry Waxman speak at UCLA last fall about his time in Congress. He described various experiences. There was a chart depicting how votes had increasingly become very partisan. During question.s I asked if Republicans had wanted to be involved in the ACA development, as a Republican friend who watches Fox News told me. Waxman said that he, as chair of the Health Committee, had approached a Republican colleague about helping in the crafting of the bill. (The way it used to be done, when bipartisanship was practiced. ) The Republican said he had been told not to do anything to work on this.
1
This article says a lot, but conveys little.
You mean you disagree but can't refute.
The goal of the ACA was noble, healthcare coverage for everyone, but its implementation was silly.
You know how the government pays for necessaries like police, fire, sewers, water, education, defense, snow removal, road repair, etc? That's what we should do with health care. Simple, elegant, and that would be the end of it.
You pay a substantial deductible, to avoid frivolous treatment, the government pays the rest according to a reasonable fee schedule promulgated by region. If a medical provider wants to charge more than the approved fee schedule the provider will have to prominently display fees in the facility and you can pay it if you want to or see someone else.
The fact that you could opt out of ObamaCare by paying a fine thwarts the plan's intention from its inception.
You know how the government pays for necessaries like police, fire, sewers, water, education, defense, snow removal, road repair, etc? That's what we should do with health care. Simple, elegant, and that would be the end of it.
You pay a substantial deductible, to avoid frivolous treatment, the government pays the rest according to a reasonable fee schedule promulgated by region. If a medical provider wants to charge more than the approved fee schedule the provider will have to prominently display fees in the facility and you can pay it if you want to or see someone else.
The fact that you could opt out of ObamaCare by paying a fine thwarts the plan's intention from its inception.
1
David Leonhardt says, in part: "Today’s Republican Party has moved so far to the right that it no longer supports any plan that covers the uninsured. Of course, Republican leaders are not willing to say as much, because they know how unpopular that position is." Republican leaders are brilliant marketers. They will present a health care (?) bill that will hurt millions of their supporters BUT they will couch it in such glowing terms that the unsuspecting Republican faithful will continue to support the myth. Now that's brilliant!
I give credit to President Obama for pursuing health insurance reform and accomplishing what he could. With that said, there are issues where he and his team failed.
1. Gave up on the public option without a fight.
2. If the ACA was going to have to pass with zero Republican support anyway, he might as well have grasped for more relief for taxpayers and less beholden to insurance companies.
3. Did a very poor job of managing the messaging both during and after passage of the bill.
Being Republican Lite buys Democrats nothing. They fail their core constituencies and those who are outside those constituencies are too far gone to be brought into the fold anyway.
1. Gave up on the public option without a fight.
2. If the ACA was going to have to pass with zero Republican support anyway, he might as well have grasped for more relief for taxpayers and less beholden to insurance companies.
3. Did a very poor job of managing the messaging both during and after passage of the bill.
Being Republican Lite buys Democrats nothing. They fail their core constituencies and those who are outside those constituencies are too far gone to be brought into the fold anyway.
1
The whole of the modern Republican Party reeks of mendacity. Everything the leaders touch, all the words that fall out of their mouths, the endless contortions and cover-ups--all reek.
Congressional Republicans are like people who keep far too many old cats in their homes. They no longer can detect the stench but their environs are uninhabitable to others. Even a short visit can make you sick.
Congressional Republicans are like people who keep far too many old cats in their homes. They no longer can detect the stench but their environs are uninhabitable to others. Even a short visit can make you sick.
Why can't the US just do as say Australia does? A 1.5% levy for healthcare on gross earnings. That's just $900 a year if you earn $60K. We have a first class public hospital system which is free for everyone and is better than private hospitals in outcomes. There are no queues. It's always free to see a bulk-billing GP doctor, which most are. No one, even millionaires, pays more than $33 for any medicine (& the poor pay only $5). And it all works. Any government that even hints at scaling back Medicare draws the fiery wrath & fury of the electorate. Australians love their socialist Medicare that looks after everyone whether you have $1 or $1 billion dollar in your bank account.
1
There is one little backdoor trojan in the Affordable Care act ( Obamacare ) that republicans\insurance companies hate the most; It is the ability of any state to apply for a waiver and set up their own Single Payer system.
Vermont came the closest, but the powers that be ( private for profit insurance companies ) cut it off at the knees, just a few years later.
The press never talks about this. It is always an abstract intellectual exercise that does not touch the actual lives that hang in the balance.
Profit motive always seems to win
Vermont came the closest, but the powers that be ( private for profit insurance companies ) cut it off at the knees, just a few years later.
The press never talks about this. It is always an abstract intellectual exercise that does not touch the actual lives that hang in the balance.
Profit motive always seems to win
2
The term "free market" is an oxymoron. It isn't free at all. It demands a profit. The private insurance companies that issue healthcare policies demand a considerable profit. A single payer system run by the government would require no such profit and would result in an immediate and substantial overall savings.
The greatest bit of political theater the Republicans created about Obamacare was the all hands all media all the time assault on "if you like your doctor, you can keep your doctor..."
That was political gold for them. President Obama probably missed out a caveat or two (including that health plans change every year, and so who can guarantee those).
But, at the core he executed on his intent: tens of millions more people received subsidized health care.
What Paul Ryan is really crowing about Trumpcare is that for the first time in history we've rolled back an 'entitlement'. Because any subsidy given to any constituency not included in the Top 10% is simply an entitlement. If it's given to the Top 10% it's a job creation measure (how did Obama policies create all those private sector jobs then??)
Shouldn't people on Obamacare have the right to ask Republicans: what about MY right to keep my doctor? Weren't/aren't you concerned about that any more? Or, was that just politics?
That was political gold for them. President Obama probably missed out a caveat or two (including that health plans change every year, and so who can guarantee those).
But, at the core he executed on his intent: tens of millions more people received subsidized health care.
What Paul Ryan is really crowing about Trumpcare is that for the first time in history we've rolled back an 'entitlement'. Because any subsidy given to any constituency not included in the Top 10% is simply an entitlement. If it's given to the Top 10% it's a job creation measure (how did Obama policies create all those private sector jobs then??)
Shouldn't people on Obamacare have the right to ask Republicans: what about MY right to keep my doctor? Weren't/aren't you concerned about that any more? Or, was that just politics?
2
Lies have consequences. Big lies have big consequences. You can't function well in the world basing behavior on lies. So, republicans are now going to learn this the hard way.
What else could the GOP do but lie about a bill that essentially ramps up the Heritage Foundation/RomneyCare model to a national level? Like Kerry's much-derided comment about the Iraq War, the GOP was in favor of the individual mandate until they were against it. Why should we believe anything they say?
Rational people want healthy citizens. The health and wellness of others is the best path to my own continued health and wellness. Citizens with vision care are better drivers. Citizens with up-to-date vaccines for themselves and their children are less likely to make me or my children ill. Citizens who have seen a dentist are not de-railed from oral pain and infection. (and they are way more pleasant to greet on the street!)
However, the U.S. model of healthcare delivery, overall, costs us 3% more of our GDP than every other nation on earth. (20%-30% more) That should not be. Bringing American costs back to reality is going to be a big struggle but we can all agree that the endpoint is worth it. Saving 3% of our GDP is the amount we spend on national defense. We should all want to put the savings to another use. All we have to do is come with a rational way to transit from where we are to where the rest of the world is.
Rational people want healthy citizens. The health and wellness of others is the best path to my own continued health and wellness. Citizens with vision care are better drivers. Citizens with up-to-date vaccines for themselves and their children are less likely to make me or my children ill. Citizens who have seen a dentist are not de-railed from oral pain and infection. (and they are way more pleasant to greet on the street!)
However, the U.S. model of healthcare delivery, overall, costs us 3% more of our GDP than every other nation on earth. (20%-30% more) That should not be. Bringing American costs back to reality is going to be a big struggle but we can all agree that the endpoint is worth it. Saving 3% of our GDP is the amount we spend on national defense. We should all want to put the savings to another use. All we have to do is come with a rational way to transit from where we are to where the rest of the world is.
Another lie of Obamacare is that it even helped the people who hated Obama, such as in states like Kentucky (Home of Mitch McConnell and Rand Paul). In Ky mostly whites have benefited greatly under ACA from both medicaid expansion and subsidies. But Gov. Matt Bevin talks out of both sides of his mouth. On the right its "we need to stop Obamacare in Kentucky" and "Obamacare is isn't working. It's killing the healthcare system." But from the left side of the mouth they don't dare mention repealing the medicaid expansion that benefit hundreds of thousands of poor white ppl. In Kentucky the median income is less than $25K a year and there are 700K white people on medicaid. But the phony Republicans repackaged ACA/Obamace as Kynect because Obama is so unpopular in KY. How exactly does the repeal help these people?
The only upside of this debacle is that maybe these ppl will finally realize that lazy black people and illegal immigrants are not the cause of all their hardships. I'm black, and I work hard and pay taxes and high insurance premiums and deductibles, and so does everyone in my family, including my elderly grandmother who requires a Medicare supplement plan. We don't qualify for subsidies under ACA, but we don't wish death on those who need assistance to afford healthcare.
The only upside of this debacle is that maybe these ppl will finally realize that lazy black people and illegal immigrants are not the cause of all their hardships. I'm black, and I work hard and pay taxes and high insurance premiums and deductibles, and so does everyone in my family, including my elderly grandmother who requires a Medicare supplement plan. We don't qualify for subsidies under ACA, but we don't wish death on those who need assistance to afford healthcare.
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In the mid 1950's the injectable Salk polio vaccine was shown to be effective in preventing polio.
The federal GOVERNMENT [ I apologize to the Times' moderator for using this pornographic word.] instituted a program of free Salk injections for school children.
I was one.
Some conservatives were horrified.
This was "Socialized medicine thru the back door."
Fortunately IKE told them they were nuts.
The program was continued and many were spared the horror of polio.
Are there still conservatives who have this cruel reactionary view point today.
The federal GOVERNMENT [ I apologize to the Times' moderator for using this pornographic word.] instituted a program of free Salk injections for school children.
I was one.
Some conservatives were horrified.
This was "Socialized medicine thru the back door."
Fortunately IKE told them they were nuts.
The program was continued and many were spared the horror of polio.
Are there still conservatives who have this cruel reactionary view point today.
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We're contemporaries, David. I remember the day we all lined up in the hallways and the public health nurses gave each of us the vaccine. I was in parochial school, and the next day many of our mothers gathered in our parish church for a Mass of Thanksgiving. The childhood scourge and the great fear of each summer was vanquished. Can you imagine something like this occurring today? The anti-vaxxers would be screaming the house down, and children would still be dying every year from a preventable disease.
I well remember lining up on the playing field at Silver Bluff Elementary, and all of us getting the vaccine. I was 6 or 7 years old. My best friend, Bob F., had gotten polio when he was 3 years old. He wore a leg brace, had a heavy limp, and had gotten multiple operations by the time we were six.
It sometimes seems that the only thing that will make conservatives accept the value of government intervention (ooh, socialism!) is people dying on the streets. And then it'll only be because they don't like the smell.
Regardless of the flaws of Obamacare, the only difference that really matters between it and the Republican "plan" is this:
Obamacare helped millions of Americans get health coverage that previously could not afford it.
The GOP would push millions of Americans who now have health coverage into losing it.
The Republican Party would be cutting the Federal deficit on the backs of ordinary people, and give a free tax pass to the administration's fellow-billionaires, which is who they really work for.
Obamacare helped millions of Americans get health coverage that previously could not afford it.
The GOP would push millions of Americans who now have health coverage into losing it.
The Republican Party would be cutting the Federal deficit on the backs of ordinary people, and give a free tax pass to the administration's fellow-billionaires, which is who they really work for.
116
Right! People, especially those prone to voting Repub, have to realize that the only time they care about Joe/Jane Sixpack, is during the elections - while the rest of the time they serve their narrow constituency of the rich and corporations. They seduce avg. peoples with their mantras of "socialism and free-choices, better, more greater, tremendous"...so they can serve their contributors and keep getting their lobbyist-perks.
"Cutting the deficit"? Then increasing military spending, but 5 times faster. What a disgusting Party.
Obamacare certainly has flaws, or really one major one - it preserves the "free-market" system of private insurance and guarantees profits for the industry. This is why it is so expensive and why the exchanges are so complicated. The way that other countries have systems with as good or better outcomes and far lower expense is actually with the "socialistic big-government takeover of health care", the threat of which Leonhardt seems to think is nonexistent. To be sure, Obamacare is not such a system despite Republican claims.
Obamacare obviously did not win votes for Democrats in 2016. Why aren't they promising a system which would really work, such as extension of Medicare?
Obamacare obviously did not win votes for Democrats in 2016. Why aren't they promising a system which would really work, such as extension of Medicare?
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The frequently heard argument, that the "flaw" in US healthcare is the participation of private insurance companies, represents a fundamental misunderstanding of healthcare internationally. Yes, Canada has a purely public system. Many N European nations use highly regulated private insurance with far better outcomes.
1
Uh, because Trump is President and the GOP controls Congress?
Private/for-profit health insurance is inherently immoral. Insurance companies make money by taking in more money than they pay out. That can be acceptable for any other type of insurance, but not for the health care kind, because health care is a fundamental right of all citizens, as inalienable any explicitly named in our Constitution. The ACA experience has proved emphatically that in order to cover all citizens, we must remove private/for-profit health insurance from this debate.
1
David, have Republicans ever advocated legislation they created that would benefit the majority of ordinary Americans? Just say No.
172
Consider the Massachusetts health care system which was formulated during a Republican Administration . "Romney Care" from which the ACA was filched.
Unfortunately, the voters who helped create this mess will remain void of facts because Fox News and their GOP partisans have come to realize that facts are nothing more that fake news.
Actually, I think the Medicare Prescription Drug, Improvement, and Modernization Act,[1] also called the Medicare Modernization Act or MMA passed in 2003, which was a GOP bill, would qualify. Of course the GOP congressman who played the largest role in initiating the legislation wound up with a half-million-dollar a year-plus job with Big Pharma, but no one's perfect.
Sadly, it is too late now. A lot of Trump supporters will be the 24 million poor folks losing health insurance for the next 9 years. To make matter worse, the so-called freedom loving Republicans just passed some bill allowing companies to test sniff around of your genetic materials. Joy!
All for what, some nebulous promise that their buggy whip skills would be preserved when most manufacturing jobs, like most office jobs, are streamlined and automated? People eager subscribe to fake news and allow trolls to sell them false hope will in the end the ones getting hurt.
This ACHA is just the first salvo. If people weren't so sheepish, they should have insisted their congressmen and congresswomen to play balls with President Obama to improve on ACA. But it is too late now. America is reaping the bitter harvest from the GOP's bad seedings
All for what, some nebulous promise that their buggy whip skills would be preserved when most manufacturing jobs, like most office jobs, are streamlined and automated? People eager subscribe to fake news and allow trolls to sell them false hope will in the end the ones getting hurt.
This ACHA is just the first salvo. If people weren't so sheepish, they should have insisted their congressmen and congresswomen to play balls with President Obama to improve on ACA. But it is too late now. America is reaping the bitter harvest from the GOP's bad seedings
94
And somehow the Rs will figure out a way to blame Obama for Trumpcare failures.
Not too late to stop the Republicans from enacting Trumpcare.
We continue to argue about the same fundamental question.
Is health care a right like free K-12 education,police and fire protection that should be provided by the government or is health care a luxury to be rationed by ability to pay.
Providing universal health care means the affluent are going to be taxed to help pay for care of the affluent and the affluent do not want to pay these higher taxes.
One way conservatives want to reduce health care expenditures is by refusing to cover preventive care and screening or by requiring high copays.
Do we want to use the market mechanism to ask a woman who feels a lump to gamble the lump is a benign cyst so she can pay rent and feed her family.
Do we want someone who sees blood in their stool to gamble the bleeding is from hemmoroids instead of having the bleeding evaluated.
Do we want patients to forgo screening [ because of cost] for diabetes or high blood pressure / cholesterol.
Conservatives are well aware that their use of the market mechanisms mean more people will die unnecessarily.
And they thunk this is a good thing.
I refer readers to an [disgusting cruel] op ed in the Washington Post that explains the conservative position.
https://www.washingtonpost.com/opinions/end-obamacare-and-people-could-d...
I would ask religious conservatives to read Matthew 25: 34-38.
Is health care a right like free K-12 education,police and fire protection that should be provided by the government or is health care a luxury to be rationed by ability to pay.
Providing universal health care means the affluent are going to be taxed to help pay for care of the affluent and the affluent do not want to pay these higher taxes.
One way conservatives want to reduce health care expenditures is by refusing to cover preventive care and screening or by requiring high copays.
Do we want to use the market mechanism to ask a woman who feels a lump to gamble the lump is a benign cyst so she can pay rent and feed her family.
Do we want someone who sees blood in their stool to gamble the bleeding is from hemmoroids instead of having the bleeding evaluated.
Do we want patients to forgo screening [ because of cost] for diabetes or high blood pressure / cholesterol.
Conservatives are well aware that their use of the market mechanisms mean more people will die unnecessarily.
And they thunk this is a good thing.
I refer readers to an [disgusting cruel] op ed in the Washington Post that explains the conservative position.
https://www.washingtonpost.com/opinions/end-obamacare-and-people-could-d...
I would ask religious conservatives to read Matthew 25: 34-38.
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I don't know what that bible verse you reference says, but don't bother with religious conservatives reading it. Most of the public ones are hypocrites.
david, thanks for the reference to the Washington Post article. Not only is the argument cruel, but it relies on a false analogy. The speed limit is the same for everybody. With Trumpcare, not everyone will have the same risk of dying - only those with lower incomes.
1
Republicans aren't abandoning healthcare because they are cruel. No, it's because they are venal: doing what their sponsors ask of them: cutting taxes for the 1%
1
Trump's health care reform takes from the poor and gives to the rich. The United States is poorer for it. Those countries with single payer healthcare are the ones that benefit on the larger scale of this dynamic - we have an acceptable level of healthcare that everyone can access, we gain from the advancements made in research and exploratory medical care that those with the best insurance policies in the states pioneer. It is depressing to reflect on who is really paying for these advances.
If this abomination goes through then one silver lining is that perhaps it is so abysmal that it will push the United States towards a single user system.
If this abomination goes through then one silver lining is that perhaps it is so abysmal that it will push the United States towards a single user system.
12
“It was the ultimate troll,” as Michael Anne Kyle of Harvard Business School put it, “for Obama to pass Republican health reform.”
David, it was also the ultimate sellout to corporate interests. Obama, by forcing the working poor to either give their money to the insurance companies, or, give their money to the government via a forced penalty, insured two outcomes:
1. Obama and the Democrats would lose the next election since there are a LOT of working poor people in the USA now, and, those folks are really not able (regardless of the mandate) to pay anyone for health insurance.....and also pay rent, food, etc.
2. That truly effective, single payer, not for profit health care is dead. Sadly.
3. Rather, "for profit" health care will be here forever. By "for profit" I mean that the CEO of Excellis/Blue Cross in Rochester, NY is able, and encouraged, to skim off $20 million in contributions from the working poor as a bonus for himself so he can continue to eat enough to stay overweight and build a mansion in Brighton, NY. Those Obama government subsidies to the poor? They are being paid to bonuses for managers at Insurance Companies ladies and gentlemen.
Socialism for the rich, and, rugged individualism for the poor. Republicans support socialism alright, as long as the public support goes to bonuses for the rich.
David, it was also the ultimate sellout to corporate interests. Obama, by forcing the working poor to either give their money to the insurance companies, or, give their money to the government via a forced penalty, insured two outcomes:
1. Obama and the Democrats would lose the next election since there are a LOT of working poor people in the USA now, and, those folks are really not able (regardless of the mandate) to pay anyone for health insurance.....and also pay rent, food, etc.
2. That truly effective, single payer, not for profit health care is dead. Sadly.
3. Rather, "for profit" health care will be here forever. By "for profit" I mean that the CEO of Excellis/Blue Cross in Rochester, NY is able, and encouraged, to skim off $20 million in contributions from the working poor as a bonus for himself so he can continue to eat enough to stay overweight and build a mansion in Brighton, NY. Those Obama government subsidies to the poor? They are being paid to bonuses for managers at Insurance Companies ladies and gentlemen.
Socialism for the rich, and, rugged individualism for the poor. Republicans support socialism alright, as long as the public support goes to bonuses for the rich.
37
As a U.S. citizen who has had life-saving treatment through Obamacare over the past three years, I can't help seeing this "repeal and replace" insanity as a form of political persecution. How is dying from lack of health care any different than dying as a result of warfare or any of the other types of persecution recognized under current international law? Seriously. Is a lawsuit along these lines in the U.S. feasible? Or seeking refugee or political asylum status in another country?
For those of us now affected, ACA and Medicaid recipients, I would recommend taking action as soon as possible. There will presumably only be a limited number of applications accepted by other nations, and there will be even more of a flood of requests as Medicare and employee-based health insurance similarly begin to go down the tubes.
I would stay in my country to fight for the rights of everyone, but my only choice may be to do that as a forcibly-exiled expat, as I have a serious chronic medical condition, and I won't be able to help anyone if I'm dead.
That's really what this is boiling down to for me.
For those of us now affected, ACA and Medicaid recipients, I would recommend taking action as soon as possible. There will presumably only be a limited number of applications accepted by other nations, and there will be even more of a flood of requests as Medicare and employee-based health insurance similarly begin to go down the tubes.
I would stay in my country to fight for the rights of everyone, but my only choice may be to do that as a forcibly-exiled expat, as I have a serious chronic medical condition, and I won't be able to help anyone if I'm dead.
That's really what this is boiling down to for me.
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To fix the individual market and ensure access to health insurance, if that had been the Republican's goal, all they needed to do was strengthen the mandate by making the penalty a bigger deterrant to remaining uninsured. But thebgail isn't about ensuring access to health care and as a result, healthier, more secure families. The Republican goal is financial (reduce federal government spending), remaking Medicaid in to a block grant, and while maintaining the tax and financial advantages that go to employers and wealthier families who receive insurance through their employers.
20
I'm an American living and working in France. Like everybody living here legally I have a green "Carte Vitale" - a magical "social security" card. When I go to the doctor, pharmacy, or any other healthcare provider I pay then I'm quickly reimbursed, up to a certain amount.
There are a few items Americans misunderstand about this system. First, everything costs less, even without insurance. Since we pay first we know the cost. The same drugs, from the same drug companies, that we purchased in the US cost much less here. Hospitals cost less, doctor visits cost less: everything costs less. Second, the system is not entirely public. There are still substantial co-pays; the sicker a person is the less these co-pays cost. There is an entire French private insurance system, called a "mutuelle," for gap coverage. Most large employers provide a mutuelle, taking payments from paychecks much like the US system. Poor people have a government mutuelle, much like Medicaid. The self-employed may purchase one on their own or forgo it at their own risk. Third, doctors are still very well paid. Finally, medical malpractice is dealt with primarily by regulators: incompetent providers will lose a license to practice rather than face enormous court fines.
This system is still imperfect but it is much better. It costs less overall, keeps people healthier, it's effective and easy to use.
There are a few items Americans misunderstand about this system. First, everything costs less, even without insurance. Since we pay first we know the cost. The same drugs, from the same drug companies, that we purchased in the US cost much less here. Hospitals cost less, doctor visits cost less: everything costs less. Second, the system is not entirely public. There are still substantial co-pays; the sicker a person is the less these co-pays cost. There is an entire French private insurance system, called a "mutuelle," for gap coverage. Most large employers provide a mutuelle, taking payments from paychecks much like the US system. Poor people have a government mutuelle, much like Medicaid. The self-employed may purchase one on their own or forgo it at their own risk. Third, doctors are still very well paid. Finally, medical malpractice is dealt with primarily by regulators: incompetent providers will lose a license to practice rather than face enormous court fines.
This system is still imperfect but it is much better. It costs less overall, keeps people healthier, it's effective and easy to use.
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Ah, but we're Americans. We are better than everyone else. We know better than everyone else. We're a SUPER power!
1
It is a wonderful system-you are very lucky.
1
Thank you; that's interesting, and more clear and complete than I've often seen.
2
Keep in mind that LBJ's congressional majority included southern Democrats who later became Republicans. The Civil Rights bill of 1965 passed with significant help from Eastern, moderate Republicans while the Dixiecrats sat on their hands. In fact more Republicans voted for the bill than Democrats. The conservative south has opposed healthcare for a very long time, principally because the benefits would accrue to people who didn't look like them. I'd love to see a survey of poor whites about their disposition to the healthcare bill. My instinct is that many would rather go without insurance than support it for minorities. Yesterday's CBO report simply confirms that we still live in a racist and divided country with racists in power positions.
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Denis, you write: "I'd love to see a survey of poor whites about their disposition to the healthcare bill. My instinct is that many would rather go without insurance than support it for minorities."
Nonsense! Many of those poor whites were people who voted twice for Obama -- enough of them to provide Trump's margin of victory in the Rust Belt. Given their support for Obama, something other than bigotry was at work.
Hint: maybe they didn't like Hillary's uninspired approach to healthcare (and other issues). Would they have been more supportive of a candidate (like Sanders) who promoted single-payer? Too late now!
Nonsense! Many of those poor whites were people who voted twice for Obama -- enough of them to provide Trump's margin of victory in the Rust Belt. Given their support for Obama, something other than bigotry was at work.
Hint: maybe they didn't like Hillary's uninspired approach to healthcare (and other issues). Would they have been more supportive of a candidate (like Sanders) who promoted single-payer? Too late now!
57
Any insurance policy is a bet. When an insurance company agrees to insure your house or car they are betting those possessions will not be destroyed or damagedd. For the most part they win the bet. With health care they are betting you won't get sick. Of course, barring accident, we all get sick and die so insurance companies are making a losing bet. The only way they can make money is by denying coverage or raising premiums high enough to cover their eventual losses and make a profit. In any casino that works properly the house always wins.
In a public health care system there is a benefit to society in keeping people healthy and no need to make a profit for shareholders. The cost of a public system is paid for in large part by the increased productivity of healthy citizens.
Living in the U.S. is a net detriment to your health. Case in point: a recent study showed that people with cystic fibrosis live on average ten years longer in Canada than in the U.S.. This isn't an outlier, the U.S. is behind the rest of the developed world in most measures of well-being. It is long past time for a real health care system in America. It is time for single payer.
In a public health care system there is a benefit to society in keeping people healthy and no need to make a profit for shareholders. The cost of a public system is paid for in large part by the increased productivity of healthy citizens.
Living in the U.S. is a net detriment to your health. Case in point: a recent study showed that people with cystic fibrosis live on average ten years longer in Canada than in the U.S.. This isn't an outlier, the U.S. is behind the rest of the developed world in most measures of well-being. It is long past time for a real health care system in America. It is time for single payer.
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Here's what I don't understand: Employers would realize an enormous decrease in HR costs under universal health care. Years ago I learned that benefits--including health insurance--cost a third again on what an employer paid in salary. This made employers think long and hard before creating a new position, or even filling a vacant one.
In my own workplace, this fact alone drove a decades-long adventure in layoffs and attrition to the point where everyone worked at least 1.5 jobs and most did the work of two or three. Nobody is happy and I guarantee that productivity and quality have suffered.
Take the burden of providing health insurance off the backs of employers, and I suspect it will unleash a lot of pent-up demand for people to fill decent jobs at living wages--exactly what the public has been clamoring for all these years.
It would also remove employers from the position of dictating which benefits their workers could enjoy. Nobody wins when the boss can say, "No birth control on my dime!"
So why aren't employers clamoring for universal health care?
In my own workplace, this fact alone drove a decades-long adventure in layoffs and attrition to the point where everyone worked at least 1.5 jobs and most did the work of two or three. Nobody is happy and I guarantee that productivity and quality have suffered.
Take the burden of providing health insurance off the backs of employers, and I suspect it will unleash a lot of pent-up demand for people to fill decent jobs at living wages--exactly what the public has been clamoring for all these years.
It would also remove employers from the position of dictating which benefits their workers could enjoy. Nobody wins when the boss can say, "No birth control on my dime!"
So why aren't employers clamoring for universal health care?
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"unleash a lot of pent-up demand for people to fill decent jobs"
It will give EMPLOYEES more freedom to move to other jobs.
1
@bystander
Well stated.
That's been my question for a long, long time
Perhaps there is some fear that taxes on payroll would increase (as they would) and the companies would lose control of how much extra they would pay.
But I doubt that any increase would be anywhere near as large as what they are now paying for insurance directly. When the whole country is in the "pool," you are spreading the cost over many, many more employers, including some very large ones (e.g. Walmart, McDonald's) that aren't currently paying. Of course those companies would pay more, but that's not a reason to not have universal insurance.
Well stated.
That's been my question for a long, long time
Perhaps there is some fear that taxes on payroll would increase (as they would) and the companies would lose control of how much extra they would pay.
But I doubt that any increase would be anywhere near as large as what they are now paying for insurance directly. When the whole country is in the "pool," you are spreading the cost over many, many more employers, including some very large ones (e.g. Walmart, McDonald's) that aren't currently paying. Of course those companies would pay more, but that's not a reason to not have universal insurance.
Americans don't understand how healthcare funding works (it is complex), but more important, Americans no longer seem to have the intellectual capacity or discipline to study what they don't understand and learn. So we're stuck with politicians spouting simplistic and usually inaccurate marketing slogans designed to stoke emotions and get reactions, but that do nothing to advance serious policy debate. The healthcare "debate" reveals a crisis in American democracy: our voters are ill-equipped to make rational and informed decisions about anything of any complexity. The voters may despise the elites, but being governed by intelligent and accomplished people who actually understand what they are doing is far better than being ruled by the charlatans and conmen who dominate in Washington today.
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The ACA's big lie is that you can fix or change massive segments of the economy with master strokes, the impact of which are not knowable at the time of inception.
The GOP response to the reckless origins of the ACA should be modest and incremental, but we have lost the ability to be either wise or small in the changes we pursue.
Got an issue with people upholding heterosexual marriage? Do away with it. Feeling nervous about immigration from failed states? Shut it down. At sea about Syria? Draw provocative red lines and then ignore them. Concerned about the treatment of mentally disturbed transgenders? Threaten all states with the loss of federal funding lest they set out to build new bathrooms. Feeling smothered by the EU? Pull out.
Citizens inflamed by social media that grossly exaggerates and whips emotion is accelerating the worst tendencies of impulsive politics, forcing us to make immediate, rash, and impulsive decisions lest the same social media tars leaders as feckless, weak, and indecisive.
It is amazing that our Founders often debated serious issues over years or conducted diplomacy that relied on trans-Atlantic communications spanning months. I think one of the saving graces of the 18th Century was that the government was not constantly wading in to the affairs of the citizens. As a result, there is hardly an event not demanding the "government", from the height of steps to the pitch of rooftops.
The more we surrender, the less we are competent to resolve.
The GOP response to the reckless origins of the ACA should be modest and incremental, but we have lost the ability to be either wise or small in the changes we pursue.
Got an issue with people upholding heterosexual marriage? Do away with it. Feeling nervous about immigration from failed states? Shut it down. At sea about Syria? Draw provocative red lines and then ignore them. Concerned about the treatment of mentally disturbed transgenders? Threaten all states with the loss of federal funding lest they set out to build new bathrooms. Feeling smothered by the EU? Pull out.
Citizens inflamed by social media that grossly exaggerates and whips emotion is accelerating the worst tendencies of impulsive politics, forcing us to make immediate, rash, and impulsive decisions lest the same social media tars leaders as feckless, weak, and indecisive.
It is amazing that our Founders often debated serious issues over years or conducted diplomacy that relied on trans-Atlantic communications spanning months. I think one of the saving graces of the 18th Century was that the government was not constantly wading in to the affairs of the citizens. As a result, there is hardly an event not demanding the "government", from the height of steps to the pitch of rooftops.
The more we surrender, the less we are competent to resolve.
10
Who's done away with heterosexual marriage? I hadn't noticed! ;-)
1
Stuart--you impeach and discredit yourself with your assertion that gay marriage does away with heterosexual marriage: not a thing you say after what you know is a lie can be taken seriously.
1
The big problem with healthcare reform is we're treating symptoms rather than root causes. Health insurance in the U.S. costs too much because healthcare in the U.S. costs too much. Specifically, how can we spend one out of every six dollars of national income on healthcare and think that is reasonable? To solve our fundamental problem, we should eliminate the rent-seeking that lets doctors in the U.S. earn multiples of what their peers in foreign countries earn and abolish the extortion rackets that health insurers and drug companies enjoy. I've reluctantly come to the conclusion that single payer funded by a VAT with cash incentives provided to citizens who have healthy lifestyles and avoid risky behaviors is the only real solution for this mess.
44
Agreed and the unhealthy "lifestyles" include the processed food we eat, the polluted air we breathe, and so - all the social determinants of health. Far more complicated and one that will involve all of us in the process of change. One added note however: 50% of ALL healthcare spending excluding insurance premiums is accounted for by 5% of the population - primarily the elderly and disabled. (Kaiser Family Foundation 2012)
Then you also better start reducing the cost to educate doctors ($150,000-$200,000 and what's the interest rate?). And you better take a look at what percentage of premiums is going to insurance company administration (check out United Healthcare's CEO pay!). I agree with your conclusions but I don't agree with bashing doctors.
Most young doctors today would have been better off becoming engineers or pharmaceutical researchers and would probably have less education debt to service. The young ones aren't making a proportionately higher salary relative to everyone else, given the careers they could have gone into. That was in the past.
Most young doctors today would have been better off becoming engineers or pharmaceutical researchers and would probably have less education debt to service. The young ones aren't making a proportionately higher salary relative to everyone else, given the careers they could have gone into. That was in the past.
Yes, but you don't have to be reluctant about it. Single-payer has problems and failures--people in other countries probably complain almost as much as we do. But health care is like clean air, something we all need in order to live. Those things cannot be handled solely by the free market. (A free market seems to inevitably degenerate to riches on one hand and poverty on the other, if it's not regulated.)
Health care now is like the original kind of fire insurance: Pay up or watch your house burn down. We decided a long time ago that that doesn't work, that fire fighters need to be organized on a larger scale.
Health care now is like the original kind of fire insurance: Pay up or watch your house burn down. We decided a long time ago that that doesn't work, that fire fighters need to be organized on a larger scale.
Republican claim they want a market-based healthcare system.
- Why then do we have monopolistic protections and import restrictions on prescription drugs?
- Why are emergency rooms required to not turn anyone away, effectively forcing hospitals and local and state governments to subsidize the uninsured through the most expensive form of care?
The cost of healthcare in the U.S. is the real issue. As a nation, we pay more and get less than any other developed nation. This is the Republican market "solution" for healthcare. (To be fair, most Democrats are not much better on the cost issue.)
- Why then do we have monopolistic protections and import restrictions on prescription drugs?
- Why are emergency rooms required to not turn anyone away, effectively forcing hospitals and local and state governments to subsidize the uninsured through the most expensive form of care?
The cost of healthcare in the U.S. is the real issue. As a nation, we pay more and get less than any other developed nation. This is the Republican market "solution" for healthcare. (To be fair, most Democrats are not much better on the cost issue.)
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Additionally, using Emergency Room for healthcare is indeed expensive. The issue is that many individuals, who lack healthcare, wait too long to seek medical care. When they finally arrive at they ER, their care is very expensive.
Hospitals need to generate these costs somewhere, called cost shifting. Therefore, Health Insurance Companies and individuals pay more to cover these costs.
The bottom line, we all pay more for health care.
The Government avoids the cost of insuring these individuals and all other pay, more in their pocket but less in ours. Of course, the Government has all the necessary monies to raise the DoD's budget.
Hospitals need to generate these costs somewhere, called cost shifting. Therefore, Health Insurance Companies and individuals pay more to cover these costs.
The bottom line, we all pay more for health care.
The Government avoids the cost of insuring these individuals and all other pay, more in their pocket but less in ours. Of course, the Government has all the necessary monies to raise the DoD's budget.
1
Saint Ronnie Reagan signed the law requiring hospitals to serve all comers. Typical of a Republican to offer a public service, but refuse to pay for it.
2
Republicans have done everything they can think of to sabotage the Affordable Care Act. Their acts of sabotage include the following.
Republican governors refusing to establish exchanges in their states.
Republican governors refusing to extend Medicaid to poor residents of their states.
The Republican House passing 60 resolutions to repeal the Affordable Care Act and refusing to consider any measure that might improve it.
Reducing the "risk corridor" payments to insurers for losses sustained on the insurance exchanges. This has led to chaos on the exchanges and rate increases since 2015.
And with the election of The Republican President, the Republican Congress finally will seize the moment and declare gottdammerung. Let's hope for a Republican funeral pyre that lights up the night sky from New York to San Francisco and marks the end of the Republican nightmare as we have come to know it.
Republican governors refusing to establish exchanges in their states.
Republican governors refusing to extend Medicaid to poor residents of their states.
The Republican House passing 60 resolutions to repeal the Affordable Care Act and refusing to consider any measure that might improve it.
Reducing the "risk corridor" payments to insurers for losses sustained on the insurance exchanges. This has led to chaos on the exchanges and rate increases since 2015.
And with the election of The Republican President, the Republican Congress finally will seize the moment and declare gottdammerung. Let's hope for a Republican funeral pyre that lights up the night sky from New York to San Francisco and marks the end of the Republican nightmare as we have come to know it.
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And yet, these same people still vote Republican, that demonstrates that truth is immaterial. A strong belief trumps all facts.
Your post is right on. Thanks
It's regrettable that the GOP's biggest lie has stood unchallenged for such a long time. ObamaCare was designed using RomneyCare as a blueprint which was based on "free-market" Republican ideas. It always, in its spirit, a was bipartisan approach: using subsidies for private insurance coverage that was income dependent, leaving the private and job dependent health insurance market in place and expanding Medicaid to cover the "near-poor". Conceptual it works like the Medicare plan D, a Republican expansion of Medicare under George W. Bush: mixing private insurances with government subsidies. Who would have thought we look back at the Bush years with nostalgia, to a time when the GOP was still a Conservative party with its platform anchored in reality.
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It wasn't that, even then. Reagan started it on the way to being worse than useless, and it's continued in that direction. Now we pay.
All of you that think the Democrats are angels of mercy, while Republicans are the boogey man, are not paying attention to actual votes, and how the Democrats always manage to cave at the magic moment when they could have fought back; how Democrats can't seem to make any convincing arguments for the right thing to do; how Democrats miss opportunities, like the possibility of having a veto proof majority sign a law that says simply, "All Americans will be covered by Medicare, paid for by tax increases on those making more than $500,000 per year."
I know longer believe that Democrats are incompetent by accident, when they do things like vote for bailouts, and for wars for oil.
Why do the Democrats lose two thirds of all elections? Is it because large majorities of the People want wars based on lies, bail outs for global banks that steal our homes, crumbling infrastructure, trade deals that give all rights to global corporations and send jobs to poorly paid foreign countries (signed by Democratic presidents), mass surveillance, bloated military budgets etc.?
Is that what most people want? I don't think so. I think the People want a party that will fight for them against crony capitalists.
About a third of Trump supporters wanted Bernie. They turned to Trump in desperation when Democrats offered them another Clinton. I talked to a NYC cop last week that wanted Bernie, but voted Trump.
Global Banks don't give corporate hacks like Hillary millions of dollars for the fun of it.
I know longer believe that Democrats are incompetent by accident, when they do things like vote for bailouts, and for wars for oil.
Why do the Democrats lose two thirds of all elections? Is it because large majorities of the People want wars based on lies, bail outs for global banks that steal our homes, crumbling infrastructure, trade deals that give all rights to global corporations and send jobs to poorly paid foreign countries (signed by Democratic presidents), mass surveillance, bloated military budgets etc.?
Is that what most people want? I don't think so. I think the People want a party that will fight for them against crony capitalists.
About a third of Trump supporters wanted Bernie. They turned to Trump in desperation when Democrats offered them another Clinton. I talked to a NYC cop last week that wanted Bernie, but voted Trump.
Global Banks don't give corporate hacks like Hillary millions of dollars for the fun of it.
2
Seniors should reflect on how dramatically the quality of their twilight years have been improved by by the reliability of that social security check arriving at their door every month and the knowledge that approx. 80% of their ever increasing medical expenses are covered by Medicare. Untold millions of seniors would be destitute today if it were not for these programs. Opposition to those programs came from one Party; the Republicans. These same Republicans are now mounting a full out assault on Medicaid with their eyes on social security and Medicare next. So I guess when the silver haired set keeps on pushing that lever for Republicans they get what they deserve.
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Unfortunately Democrats buy into most of the premises that let Republicans make those arguments. They repeat the lies that there is no money, that the era of big government is over, that private companies are more efficient than government, etc.
Once you agree to all of the false premises, it is hard to argue against the false conclusions.
There is plenty of money. Productivity is up 40% since 1980. That is 40% more cash for the same amount of work. Where did it all go? The bank accounts of the global billionaires.
Government is still growing, but what does it do? It grants giant, no bid, cost plus contracts (cost plus means that no matter how inefficient they are they are guaranteed a profit) to global corporations to do what union employees and government managers use to do for a lot less money. We have privatized most of our national security, our prisons, etc, and what do we have to show for it? A push to privatize the school system, using tests designed by global corporations to prove our schools are failing.
The efficiencies of global corporations come from hiring foreigners to do work for a couple of dollars a day, in countries where they can pollute freely. They come from refusing to pay the pensions and healthcare their workers were promised, getting government to let them get away with spinning off their responsibilities into indebted corporations, while they keep the profitable corporation with only profits. They come from tax breaks and bail outs.
Once you agree to all of the false premises, it is hard to argue against the false conclusions.
There is plenty of money. Productivity is up 40% since 1980. That is 40% more cash for the same amount of work. Where did it all go? The bank accounts of the global billionaires.
Government is still growing, but what does it do? It grants giant, no bid, cost plus contracts (cost plus means that no matter how inefficient they are they are guaranteed a profit) to global corporations to do what union employees and government managers use to do for a lot less money. We have privatized most of our national security, our prisons, etc, and what do we have to show for it? A push to privatize the school system, using tests designed by global corporations to prove our schools are failing.
The efficiencies of global corporations come from hiring foreigners to do work for a couple of dollars a day, in countries where they can pollute freely. They come from refusing to pay the pensions and healthcare their workers were promised, getting government to let them get away with spinning off their responsibilities into indebted corporations, while they keep the profitable corporation with only profits. They come from tax breaks and bail outs.
Destitute or dead...
...but they are dragging the rest of us with them.
Just what, pray tell, is so wrong with "socialistic big-government" healthcare? My Medicare along with my (private insurance) supplemental policy covers my medical expenses as well or better than any insurance I ever received from an employer (with the possible exception of my 3+ years in the Army, but, oh, that was also paid for by Uncle Sam).
Medicare is not "free," by the way. Oh, the taxes deducted from my paychecks over the years were really little more than a pittance, certainly nowhere near enough to cover much more than an xray and a cast for a simple arm fracture. Today, since Social Security is not my only income source, something over $150 is deducted from my SS check each month. My supplemental policy is a few cents less than $160 each month. Every January I see my dermatologist for my semi-annual follow-up for a skin cancer removed a decade ago. There, I pay my annual Medicare deductible of about $175.
My supplemental policy rises about $10 every year, but I'm not charged 5X more because I'm old. In point of fact, except for my first year on Medicare, when I had a colonoscopy and an aortic ultrasound (Dad and his dad had aneurysms) as part of my "welcome to Medicare" physical, I have paid more into the program than I have taken out, more, in fact, than during 45 years of employment taxes.
All this weeping, wailing and gnashing of teeth is ridiculous.
Medicare. For every American.
Medicare is not "free," by the way. Oh, the taxes deducted from my paychecks over the years were really little more than a pittance, certainly nowhere near enough to cover much more than an xray and a cast for a simple arm fracture. Today, since Social Security is not my only income source, something over $150 is deducted from my SS check each month. My supplemental policy is a few cents less than $160 each month. Every January I see my dermatologist for my semi-annual follow-up for a skin cancer removed a decade ago. There, I pay my annual Medicare deductible of about $175.
My supplemental policy rises about $10 every year, but I'm not charged 5X more because I'm old. In point of fact, except for my first year on Medicare, when I had a colonoscopy and an aortic ultrasound (Dad and his dad had aneurysms) as part of my "welcome to Medicare" physical, I have paid more into the program than I have taken out, more, in fact, than during 45 years of employment taxes.
All this weeping, wailing and gnashing of teeth is ridiculous.
Medicare. For every American.
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You have underestimated the cost of your Medicare insurance. Although you do pay a pittance, the rest of your insurance cost is covered by working people paying Medicare and general taxes. Moving to a Medicare-for-all program would require a sharp tax increase. Provided that employers, relieved of the burden of health insurance, raised wages in compensation, this would clearly be a more efficient way to finance healthcare, but that's a big "if". However, your argument that Medicare costs only a few hundred dollars per month per person is ludicrous.
Medicare-for-all, while a worthy goal, would involve a large tax increase, hopefully balanced by a large wage increase. Explaining that and getting agreement from the American people would be an enormously difficult task, especially when you look at the furor invoked by the much smaller ACA change. I would strongly doubt that M-f-a is an achievable goal.
Medicare-for-all, while a worthy goal, would involve a large tax increase, hopefully balanced by a large wage increase. Explaining that and getting agreement from the American people would be an enormously difficult task, especially when you look at the furor invoked by the much smaller ACA change. I would strongly doubt that M-f-a is an achievable goal.
2
And medicare has 3% administrative overhead, while private insurance companies average 14% overhead. Medicare is 11% cheaper, right there.
1
By the way you might want to reevaluate that Medicare supplement policy. The private companies that sell these policies advertise that Medicare covers about 80 % of costs but those are allowable costs which in my area leaves the individual responsible for only about 4% of the original charges before being reduced to the allowable charge.
2
I keep thinking about the 2008 presidential campaign. During the primaries, Democrats offered dueling healthcare proposals. Even John McCain had one.
It is another Republican distortion, if not a lie, for them to ignore that President Obama had a mandate to produce something new for healthcare. Mr. Leonhardt does a pretty good job of explaining what that turned out to be, but he doesn't mention it was very different from what candidate Obama proposed.
Republicans have done well with the politics of obstruction and they have contrived contorted explanations that make their obstruction sound more rational than it is. Now, we see the ugly underside of their ideology.
Many Republicans think freedom means the right to have whatever you can afford to buy and economic distribution is not only ineffective, but immoral. The anti-tax group is always lurking with its appeal to those who think their taxes are too high. Free marketers continue to think that competition will fix whatever is wrong.
The effectiveness of these positions is driven by very sophisticated public relations. Remember Rand Paul and Mitch McConnell caught on an open mic saying that the Democrats probably hadn't focus-tested a message? People don't even know they are being manipulated.
Those cost "savings" in the CBO report will be tragically expensive for some people. Some Republicans are opposing AHCA because there aren't enough of those "savings." There's a real danger voters will continue to be fooled.
It is another Republican distortion, if not a lie, for them to ignore that President Obama had a mandate to produce something new for healthcare. Mr. Leonhardt does a pretty good job of explaining what that turned out to be, but he doesn't mention it was very different from what candidate Obama proposed.
Republicans have done well with the politics of obstruction and they have contrived contorted explanations that make their obstruction sound more rational than it is. Now, we see the ugly underside of their ideology.
Many Republicans think freedom means the right to have whatever you can afford to buy and economic distribution is not only ineffective, but immoral. The anti-tax group is always lurking with its appeal to those who think their taxes are too high. Free marketers continue to think that competition will fix whatever is wrong.
The effectiveness of these positions is driven by very sophisticated public relations. Remember Rand Paul and Mitch McConnell caught on an open mic saying that the Democrats probably hadn't focus-tested a message? People don't even know they are being manipulated.
Those cost "savings" in the CBO report will be tragically expensive for some people. Some Republicans are opposing AHCA because there aren't enough of those "savings." There's a real danger voters will continue to be fooled.
66
Not when they lose their insurance
"he doesn't mention it was very different from what candidate Obama proposed."
Actually, the ACA was very close to what Pres. Obama proposed as a candidate in 2008:
"Senator Obama has proposed a plan for universal coverage that would build on the current system of mixed private and public group insurance. Some of its features are similar to the universal coverage law now being implemented in Massachusetts. All employers, other than small businesses, would be required to offer health insurance to their employees or contribute to the cost. Eligibility for Medicaid and SCHIP would be expanded. Small businesses, self-employed individuals, and people who do not have coverage through their employers, Medicaid, or SCHIP would be able to purchase a plan through a new insurance market called the National Health Insurance Exchange."
http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2...
Actually, the ACA was very close to what Pres. Obama proposed as a candidate in 2008:
"Senator Obama has proposed a plan for universal coverage that would build on the current system of mixed private and public group insurance. Some of its features are similar to the universal coverage law now being implemented in Massachusetts. All employers, other than small businesses, would be required to offer health insurance to their employees or contribute to the cost. Eligibility for Medicaid and SCHIP would be expanded. Small businesses, self-employed individuals, and people who do not have coverage through their employers, Medicaid, or SCHIP would be able to purchase a plan through a new insurance market called the National Health Insurance Exchange."
http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2...
Obama's mistake was the same mistake he always made, lead with your compromise position.
If Obama had pushed for a universal single payer system, he probably could have gotten it. If he had pushed for a "public option,' he probably could have gotten that. (Unfortunately he did not even let experts on those things testify at hearings.) Universal single payer is what the People want. (All of the voters that voted for Trump at Bernie's town hall in McDowell County think that universal healthcare is a right according to their rounds of applause.)
Even if Obama had pushed for those things and not gotten them, the Republicans would have had to push Romney Care as the alternative. Then Obama could have compromised with them and let them implement that. It would be the same thing as Obama Care, but Republicans would own it. They would not been able to attack it so mercilessly.
Why did Obama negotiate everything so badly, always starting out in the middle, even though a highly trained lawyer like him knows that you have to start at your extreme to meet the adversary near the middle? I don't know, but I suspect it was not incompetence.
If Obama had pushed for a universal single payer system, he probably could have gotten it. If he had pushed for a "public option,' he probably could have gotten that. (Unfortunately he did not even let experts on those things testify at hearings.) Universal single payer is what the People want. (All of the voters that voted for Trump at Bernie's town hall in McDowell County think that universal healthcare is a right according to their rounds of applause.)
Even if Obama had pushed for those things and not gotten them, the Republicans would have had to push Romney Care as the alternative. Then Obama could have compromised with them and let them implement that. It would be the same thing as Obama Care, but Republicans would own it. They would not been able to attack it so mercilessly.
Why did Obama negotiate everything so badly, always starting out in the middle, even though a highly trained lawyer like him knows that you have to start at your extreme to meet the adversary near the middle? I don't know, but I suspect it was not incompetence.
141
Hm. DJT is a former Democrat and lifetime New Yorker (this is not a compliment) who saw an opening on the Republican side. He's endorsed both Bill and Hillary on separate occasions.
Now we have a follow-on to the disaster that is Obamacare, which promises even more of the impossible than the original. If it passes in anything like its current form, it will be as much of a tombstone for the Republicans as the original has been for the Democrats.
From my perspective as someone with a somewhat rare, debilitating disease,
Obamacare serves two constituencies: those who receive subsidies and pay a small fraction of the price paid by the diligent Dilberts, and the congratulations-to-Me crowd who have employer plans and are blind to this monstrosities' actual effects. O'care II, as proposed, will be a light version of the same; less destructive at first, but after a media/DNC campaign to bring subsidies back to the 'deserving' it will be 85% similar to the original.
Obamacare did not deliver because it promised the impossible. Per Gruber this was understood to be the case, with the tacit notion that it would eventually lead to a form of government monopoly administered by the current insurance companies. It was simply assumed that a monopoly ("Single Payer") is a Good Thing, without asking "Are we really so wise that We Know Best?"
Now we have a follow-on to the disaster that is Obamacare, which promises even more of the impossible than the original. If it passes in anything like its current form, it will be as much of a tombstone for the Republicans as the original has been for the Democrats.
From my perspective as someone with a somewhat rare, debilitating disease,
Obamacare serves two constituencies: those who receive subsidies and pay a small fraction of the price paid by the diligent Dilberts, and the congratulations-to-Me crowd who have employer plans and are blind to this monstrosities' actual effects. O'care II, as proposed, will be a light version of the same; less destructive at first, but after a media/DNC campaign to bring subsidies back to the 'deserving' it will be 85% similar to the original.
Obamacare did not deliver because it promised the impossible. Per Gruber this was understood to be the case, with the tacit notion that it would eventually lead to a form of government monopoly administered by the current insurance companies. It was simply assumed that a monopoly ("Single Payer") is a Good Thing, without asking "Are we really so wise that We Know Best?"
8
In reply to your last question: We can look to the examples of other wealthy countries and see what works there. It appears that, without exception, they all have some level -- often a high one -- of government-funded health insurance.
We don't have to reinvent the wheel, just be smart enough to learn from the experience of others.
We don't have to reinvent the wheel, just be smart enough to learn from the experience of others.
15
The ACA promised to insure more and to lower the rate of medical inflation. In spite of Republican sabotage, the ACA has accomplished both goals. In fact the costs are lower than the CBO projections. The enrollment number is lower than hoped entirely due to Republican Governors refusing the Medicaid expansion, denying millions of Florida and Texan working poor life saving insurance. Someday the divide and conquer Republican strategy will be seem for what it is, and the Party will pay the ultimate price. Maybe that is the silver lining of the tRump presidency.
2
Why do countries like Denmark and Germany, etc. all pay half of what the US pays and they get universal coverage?
And we have parts of the country where infant mortality rates are the same as Botswana.
On the other hand, we have gotten our electricity from regulated monopolies for 100 years.
Nobody seems to have a problem with it.
And we have parts of the country where infant mortality rates are the same as Botswana.
On the other hand, we have gotten our electricity from regulated monopolies for 100 years.
Nobody seems to have a problem with it.
1
Before Medicare was enacted some 50 years ago, Doctors were against it because the reimbursements were lower than what they wanted to charge. It became law anyway and as a result, every person age 65 and up suddenly had insurance. I well remember my impoverished grandmother, who surely who never have had any treatment for anything if not for Medicare.
Within a couple of years, an unintended consequence was noted. The physician's incomes had doubled! Although surely their volume had gone up dramatically, they couldn't argue with success. Since then, Medicare has remained one of the most popular government programs and for good reason.
A single-payer system, ie Medicare for all, would dramatically improve health care and the overall quality of life in this country. There are great inefficiencies involved in dealing with a patchwork of insurances, each one with different rules, many of them arbitrary. Many physician's offices hire someone just to deal with it. Think of all the waste, and the fraud. Think of insurance company executives' huge salaries.
We could probably cover everybody for what we are spending now.
Within a couple of years, an unintended consequence was noted. The physician's incomes had doubled! Although surely their volume had gone up dramatically, they couldn't argue with success. Since then, Medicare has remained one of the most popular government programs and for good reason.
A single-payer system, ie Medicare for all, would dramatically improve health care and the overall quality of life in this country. There are great inefficiencies involved in dealing with a patchwork of insurances, each one with different rules, many of them arbitrary. Many physician's offices hire someone just to deal with it. Think of all the waste, and the fraud. Think of insurance company executives' huge salaries.
We could probably cover everybody for what we are spending now.
1013
It's not just "many physician offices" that hire someone to do billing. I'm a physician, and I don't know of *any* practices that do not have a dedicated billing person on their staff, or use a billing company.
I can tell you from personal experience that a mind-boggling amount of manpower and money is spent on dealing with a dozen or 15 different insurance bureaucracies, whose criteria and procedures change every year. You have to keep track of changing copays, changing deductibles, changing formularies, changing billing procedures, and changing reimbursement rates. Times a dozen or more insurance plans. Not to mention keeping track of patients' changes of insurance as they change employment, requiring new prior authorizations for medications and treatments that patients have been stable on for years, just because they now have Aetna instead of Cigna. I used to spend about 4 hours a week doing prior authorizations, much of it just making multiple phone calls to find out whether for this patient's policy the auth is done by the insurance company or whether it's delegated to Caremark or some other carve-out medication management outfit. Finally we devoted some administrative time to help out, and now I put in about an hour a week (plus more time for the admin assistant to do the phone calls and wait on hold).
Please, please, please, can we just have a single payer system?
I can tell you from personal experience that a mind-boggling amount of manpower and money is spent on dealing with a dozen or 15 different insurance bureaucracies, whose criteria and procedures change every year. You have to keep track of changing copays, changing deductibles, changing formularies, changing billing procedures, and changing reimbursement rates. Times a dozen or more insurance plans. Not to mention keeping track of patients' changes of insurance as they change employment, requiring new prior authorizations for medications and treatments that patients have been stable on for years, just because they now have Aetna instead of Cigna. I used to spend about 4 hours a week doing prior authorizations, much of it just making multiple phone calls to find out whether for this patient's policy the auth is done by the insurance company or whether it's delegated to Caremark or some other carve-out medication management outfit. Finally we devoted some administrative time to help out, and now I put in about an hour a week (plus more time for the admin assistant to do the phone calls and wait on hold).
Please, please, please, can we just have a single payer system?
2
Medicare for all would be wonderful if they stopped allowing doctors to opt out. Many top orthopedists and almost all psychiatrists in NYC do not participate at all.
1
Fifty years ago, the local doctor lived in the largest house in the neighborhood. Local no more under the current system of insurance and treatment, the doctor now lives in a rich-person's neighborhood and expects to continue to do so by performing unnecessary tests and procedures billed to insurance companies and Medicare/Medicaid.
What we need is not only single-payer health care, but outcome-based medicine.
What we need is not only single-payer health care, but outcome-based medicine.
1
The health insurance/pharma industries wield way too much power in Washington, and symbolize the rotten effects of money on our representatives. Health insurance companies are driven by profit motives, and the more health care that they deny, the more money they leech out of the system. A great deal of their profits finds its way into the pockets of "our" lawmakers, who are enjoying "Cadillac" health plans paid for by taxpayers, refusing to extend those benefits to all Americans. This is all due to the campaign contributions and lobbying cash, aka bribes and graft, from the industry. Single-payer is the only option proven to work around the world. The GOP apparently doesn't care about American taxpayers suffering and dying.
187
Apparently, neither do Democrats (care about American taxpayers...). Obama campaigned as a supporter of a single-payer system, until he got close to victory. He sold us out. How'd that work for his legacy?
1
"What is apparent, is true. What is obvious is real." Arthur Ross, screenwriter of
"Creature from the Black Lagoon".
"Creature from the Black Lagoon".
The average annual Republican shortfall is 19 million. Of that number, there are surely 3 million whose lack of insurance is temporary, including people in their twenties who are upwardly mobile. There probably are another million who'd prefer to spend their money on something else. That leaves the great great bulk -- adults earning 100-133% of the poverty level. Their children are all covered by CHIP. And subtract 1 million for those who have the wealth to afford insurance, despite their low income. That leaves about 14 million Americans -- 4.4% of the population -- who lack coverage under Trumpcare and are covered by Obamacare. The 4.4% are not the poorest --they fall into a donut hole of non-coverage which is pretty much nonsensical.
Bottom line, the two insurance programs vary by a small percentage of the population whose ineligibility is random and nonsensical. Eventually, the donut hole will surely be filled. Hopefully, we will then get around to what really matters -- health care, not health insurance.
Bottom line, the two insurance programs vary by a small percentage of the population whose ineligibility is random and nonsensical. Eventually, the donut hole will surely be filled. Hopefully, we will then get around to what really matters -- health care, not health insurance.
17
Have you forgotten that those children have parents whose lack of insurance would surely have devastating consequences if those parents fall ill? Have you forgotten that 14 million people is roughly equivalent to the number of illegal aliens living in our nation, who reputedly are all criminals and who cost the United States millions of jobs? And have you forgotten, or do you just ignore, the fact that the insurance figures are surely going the wrong way?
81
"4.4%" is only small if your no part of it. You'd be singing a different tune if you were sick and couldn't afford insurance. Here's an idea. Why don't you quit your health insurance plan for one year and then tell the rest of us if you still feel that 4.4% in "only".
Good points Ray. It's also true that illegal immigrants, many paying no taxes, are themselves taxing ERs as the source for their care. We pay for that coverage through increases in our premiums.
The flaw in all of this is the assumption that healthcare is a right rather than a privilege to be earned. It's much more complicated than that, because we are talking about lives. Certainly a country that presumes to protect "the least amongst us" can come up with an equitable solution. That is also complicated, and easier said than done.
The flaw in all of this is the assumption that healthcare is a right rather than a privilege to be earned. It's much more complicated than that, because we are talking about lives. Certainly a country that presumes to protect "the least amongst us" can come up with an equitable solution. That is also complicated, and easier said than done.
"Even Lyndon Johnson, with big congressional majorities, could pass programs only for the elderly and the poor — over intense opposition that equated Medicare with the death of capitalism. So Democrats slowly moved their proposals to the right, relying more on private insurance rather than government programs. As they shifted, though, Republicans shifted even farther right."
Thus the Grinchly Oligarchic Party, with respect to most economic issues, effectively assured that Democratic politicians transformed their own Party into a neoliberal, right-of-center pro-Wall-Street Party. The GOP moved so far to the right that it nearly fell off the edge of its Flat Earth. The neoliberal Dems, lemmings that they are, followed.
So it came to pass that, with respect to economic policy, we could vote for one or the other of two major parties, neither of which offered a progressive, pro-worker, pro-consumer agenda. The Democrats abandoned their New Deal ideals and offered the American people an echo, not a choice.
Is it any wonder that Hillary Clinton, with her Wall Street connections and neoliberal baggage, lost the election to Donald Trump? Jobs and the economy were and continue to be the major political issues. The Republicans offered the people French vanilla ice cream, the Democrats plain vanilla. Trump seemed to offer something completely different: populist pistachio nut.
Thus the Grinchly Oligarchic Party, with respect to most economic issues, effectively assured that Democratic politicians transformed their own Party into a neoliberal, right-of-center pro-Wall-Street Party. The GOP moved so far to the right that it nearly fell off the edge of its Flat Earth. The neoliberal Dems, lemmings that they are, followed.
So it came to pass that, with respect to economic policy, we could vote for one or the other of two major parties, neither of which offered a progressive, pro-worker, pro-consumer agenda. The Democrats abandoned their New Deal ideals and offered the American people an echo, not a choice.
Is it any wonder that Hillary Clinton, with her Wall Street connections and neoliberal baggage, lost the election to Donald Trump? Jobs and the economy were and continue to be the major political issues. The Republicans offered the people French vanilla ice cream, the Democrats plain vanilla. Trump seemed to offer something completely different: populist pistachio nut.
91
only to people who were unwilling to see him for what he is or do even the most basic homework
Dear Bjelland: I agree with almost all of your thesis. Where you lose me is your explanation of why Hillary lost the election. Her loss was due to several factors including: republican gerrymandering of voting districts, republican voter suppression, republican attempts to scandalize Hillary's, Comey's comments about reopening Hillary email investigation, Russian hackers and the media who allowed Trump and his surrogates to go unchallenged when they lied. As you know, she actually won the popular vote.
1
If deep red states continue to elect ideologically blind people whose public policy ideas are as thin as their knowledge, we will continue to tread water until we perish from exhaustion. It doesn't seem to dawn on them that leaving millions of people without minimum coverage isn't good for the country. How is the economy improved if we have millions languishing in sickness
or dying prematurely. And, at the same time, how is the economy improved by giving more money to rich people who will probably won't need to use it?
or dying prematurely. And, at the same time, how is the economy improved by giving more money to rich people who will probably won't need to use it?
90
GOP'ers are pursuing dogma in the face of objective reality, violating their own tenets of ' disruption ' and capitalism - they cannot point to any place on the planet where ' free markets ' deliver healthcare to a nation.
In every other situation, capitalism, competitive enterprise, and free markets would adapt their business model to what is actually known to work, adapting ' best practices ' from what can be observed from competitors, instead of a smoke-and-mirrors approach of selling snake oil with lies.
The most pathetic episode ever of Bad Congressional Theatre, except we're dealing with real life flesh and blood Americans, same as when we send troops into battle.
Craven GOP'ers in D.C., who are all members of the 1% by virtue of their salaries, will be voting themselves tax cuts by voting for Trumpcare, in blatant exchange for other Americans lives - repealing Obamacare will kill at least some American citizens in exchange for tax cuts for those voting ' Yes ' for Trumpcare.
Thanks, Comey, McConnell, Ryan and Priebus:
http://www.huffingtonpost.com/entry/harry-reid-russia-donald-trump_us_58...
In every other situation, capitalism, competitive enterprise, and free markets would adapt their business model to what is actually known to work, adapting ' best practices ' from what can be observed from competitors, instead of a smoke-and-mirrors approach of selling snake oil with lies.
The most pathetic episode ever of Bad Congressional Theatre, except we're dealing with real life flesh and blood Americans, same as when we send troops into battle.
Craven GOP'ers in D.C., who are all members of the 1% by virtue of their salaries, will be voting themselves tax cuts by voting for Trumpcare, in blatant exchange for other Americans lives - repealing Obamacare will kill at least some American citizens in exchange for tax cuts for those voting ' Yes ' for Trumpcare.
Thanks, Comey, McConnell, Ryan and Priebus:
http://www.huffingtonpost.com/entry/harry-reid-russia-donald-trump_us_58...
146
To think that the new administration is cutting taxes for themselves is the actual definition of paranoia.
leftoright - Waving away of inconvenient facts provable by math does not make those facts go away:
https://www.nytimes.com/2017/03/10/business/tax-cuts-affordable-care-act...
Voters must be plainly told the cost in human lives of what legislators are voting for/against; the town halls have helped put faces on the cold hard numbers.
https://www.nytimes.com/2017/03/10/business/tax-cuts-affordable-care-act...
Voters must be plainly told the cost in human lives of what legislators are voting for/against; the town halls have helped put faces on the cold hard numbers.
1
Are you going to chant daily, "Thanks, Comey, McConnell, Ryan and Priebus" for the next 4 years?
1
Maybe a bigger lie is that the rich care about the poor, as in DeVos' claims about charter schools helping kids get a good education, the worry that a higher minimum wage would put people out of work, or that helping feed children in school somehow weakens their moral fiber. Where is Jonathan Swift when we need him?
872
@George
Rather than take to these pages with ad hominem attacks on people and policies, write in your weekly sacrifice to others: how much of your income you give away, places where you work in service to others, the number of times each week that you lift up something not favorable to you and your family. That is the only expression of "George" that matters. The walk.
Many Americans see the hash done by large bureaucracies once they step in to do what citizens could and should do for each other, and they want no more of it.
If we need universal health care, let's decide what the minimum viable provision of care looks like and be done with it. If we are going to publicly educate our children, set standards and measure. The conflicts emerge when Progressives demand more time or more money to work out their visibly intractable social challenges. If the citizens are not willing to care for each other, holding back a rotting culture is not the job or place of a larger government.
Rather than take to these pages with ad hominem attacks on people and policies, write in your weekly sacrifice to others: how much of your income you give away, places where you work in service to others, the number of times each week that you lift up something not favorable to you and your family. That is the only expression of "George" that matters. The walk.
Many Americans see the hash done by large bureaucracies once they step in to do what citizens could and should do for each other, and they want no more of it.
If we need universal health care, let's decide what the minimum viable provision of care looks like and be done with it. If we are going to publicly educate our children, set standards and measure. The conflicts emerge when Progressives demand more time or more money to work out their visibly intractable social challenges. If the citizens are not willing to care for each other, holding back a rotting culture is not the job or place of a larger government.
1
What does Betsey DeVos actually know about education? She has no formal training or experience, it's only her personal opinion backed up w/ loads of Amay $....clearly not qualified for this office....and I think there is a conflict of interests as the charter school business is lucrative for her personally. Again she has no background in education.....that seems pretty clear to me. BTW I tutor & teach college as an adjunct professor. I am offended by her ignorance.
1
This morning it sure sucks to be GOP as pertains to healthcare.
Thanks Obama!
Thanks Obama!
33
When your whole political business model is based on lying there are bound to be problems in the long run.
Like my mother always said, it's much easier to tell the truth.
Like my mother always said, it's much easier to tell the truth.
783
You can't tell the truth when you represent the one percent and the rest of are just their fodder.
The only way for the GOP to slink away from this disaster is to continue making all the right noises, pretending to care about those whose votes they need, while the bill dies an ugly death which they blame on the Democrats. They're confident that their base is gullible enough to fall for it, and I see no evidence that they're wrong.
689
A fair slice of the base knows that the GOP in the main are simply the Democrats with different hair, mannerisms, and a slightly different set of donor masters. They've been practicing failure for 6 years and will continue to do so.
I believe the Republicans are more easily seen through and will be on a shorter leash, thus I prefer them to the more charismatic, cult-like Democrats.
I believe the Republicans are more easily seen through and will be on a shorter leash, thus I prefer them to the more charismatic, cult-like Democrats.
1
@Demers
"...their base is gullible enough"
I laugh when reading partisans. It's as if this is a parlor game fighting for voters rather than an adult discussion of financially viable and sustainable decision-making.
Promise, and let the execution arrive years down the road once "our voters" are dug in and resistant to letting go of the new service, entitlement or law.
Democracy is becoming nothing more than the purchase of votes with often unfulfillable promises. It is sad. And Liberals and Conservatives are little distinguished.
"...their base is gullible enough"
I laugh when reading partisans. It's as if this is a parlor game fighting for voters rather than an adult discussion of financially viable and sustainable decision-making.
Promise, and let the execution arrive years down the road once "our voters" are dug in and resistant to letting go of the new service, entitlement or law.
Democracy is becoming nothing more than the purchase of votes with often unfulfillable promises. It is sad. And Liberals and Conservatives are little distinguished.
1
Obamacare has been a blindlingly clear disaster for me, my family, and millions of Americans. It was sold to me, my family, and millions of Americans based on lies. I voted for Obama and I am sorry I did. Democrats own the lies and Obamacare which is spiraling out of control. I voted for Republicans to fix Obamacare, among many other disasters of socialism. If they don't fix it, the Republicans and Trump will own it and I will vote for Democrats if they come up with something better. We need to hold all politicians accountable regardless of party affiliation, and we need to see through the smoke and mirrors of the media in order to hold these politicians, ALL of them, accountable.
10
I wish you had been specific as to the way in which the ACA has been a disaster for you. In my experience, my premiums stopped skyrocketing subsequent to the passage of the ACA. That has been the experience of my friends who also have to pay for their own insurance.
Whatever our experiences, it is clear on the facts that other advanced countries provide high quality medical care through universal coverage at a far lower cost. I lived overseas and saw this first hand. It saddens me that so many Americans don't know how bad we have it and don't know how vile the Republican Party is to view health care as a privilege for those with money and not a basic right that benefits everyone through better health.
Whatever our experiences, it is clear on the facts that other advanced countries provide high quality medical care through universal coverage at a far lower cost. I lived overseas and saw this first hand. It saddens me that so many Americans don't know how bad we have it and don't know how vile the Republican Party is to view health care as a privilege for those with money and not a basic right that benefits everyone through better health.
303
@Scott K. in Atlanta. I certainly can't speak about your family, but your claim that the ACA has been a "clear disaster" for millions of Americans does not hold water.
We do not have and have never had "socialism," though the GOP threw that word around a lot re the ACA. For anyone who believed that Trump could provide better care cheaper and cover everyone, I have a bridge I'd like to sell...
We do not have and have never had "socialism," though the GOP threw that word around a lot re the ACA. For anyone who believed that Trump could provide better care cheaper and cover everyone, I have a bridge I'd like to sell...
203
Scott, I can't speak to your specific circumstances, but I can relate my own. My initial premiums (without subsidy) under the ACA went down by $190 per month because I was offered a rate based on my age, rather than one rated for my pre-existing condition (long-standing chronic kidney disease). Since 2014, my premium has gone up substantially, but it is probably still less than I would be paying under the old rules (where I would be charged more because of my kidney disease). Given that more than 80% of people in the marketplace are getting subsidies, I doubt there are really many people who are that bitter about their ACA policies. The old rules favored the healthiest customers and left sicker people with either no insurance or with unaffordable policies. The new rules treat everyone more or less the same.
12
24 million will lose health insurance coverage. Paul Ryan is the Grim Reaper, the Speaker of the Death Panel.
But wait! Won't big tax cuts for the rich make it all OK?
But wait! Won't big tax cuts for the rich make it all OK?
159
The rich will each give their 7 million a year tax cut to fund not-for-profit hospitals and doctors offices. Doctors will be paid by them directly without needing an army of clerks to jump through a separate hoop for each insurance provider, and it will rain adorable kittens and puppies on May Day.
I know these things to be true because I heard it on hate radio. If Rush says it, you know its real.
I know these things to be true because I heard it on hate radio. If Rush says it, you know its real.
1
Most Americans do not understand how the economy/politics work. They think in rather practical terms, like, if you have a big deficit you're in big trouble and something must be done and the notion that more federal involvement means more communism. Thinking of this kind blinds Americans to the benefits and sensibility of programs like Obamacare. And in their "blindness" they become fearful. . . and vulnerable to opportunists like Trump and Bannon. I'm neither smart enough nor influential enough to correct the economic misunderstands of too many of our citizens. I hope those who can will speak up and proclaim their wisdom loudly and clearly.
80
Longhorn: I feel exactly the same way! There is such a complete lack of understanding of what insurance is and how it works. The main point that Trump supporters seem to make over and over is that they object to being “forced” by the government to buy something they don’t “want,” presumably health insurance (socialism!). They claim that for whatever reason, they don’t “need” insurance. They fail to understand that health insurance is a form of responsible gambling, and not buying health insurance is a form of irresponsible gambling. Health care gets paid for one way or another, and the more people who refuse to buy insurance, the heavier burden on those of us who do. The mandate was designed to fix that, and it makes sense, but if and only if you actually understand how insurance works and don’t have a knee-jerk reaction to “socialism.”
3
It is not that people aren't smart, its that global corporate mass media lies to them all of the time, pretending that it's "liberal" while actually it pushes a bunch of myths about how tax cuts for the rich grow the economy, terrorism is an existential threat (while it has actually killed less than 6,000 Americans over decades) that demands cuts to civil liberties and ever growing surveillance and militarized police forces; that protesting is a waste of time (until Trump got elected, and suddenly the media is advertising them--whats that about?); that there is no money, even though productivity is up 40% since 1980, and they have taken all of that extra money as profits and use it to play the global derivatives market (with a nominal value many times the actual global economy), etc.
Fake news is a thing because the people don't trust corporate news because it continually lies to us. Some of us are good at reading between the lines, and finding alternate news sources that actually cite real documents, do real research, and come to sound (if not always popular conclusions, like the war in iraq was based on lies, which you didn't believe when we told you). Some us, are smart enough to know corporate news is lying to us, but don't have the skills to do evidence based research, so they believe Breitbart, etc, outlets that are also funded by global billionaires, but cater to those that hate.
CNN, MSNBC, the NY Times, etc, are not telling the whole truth.
Fake news is a thing because the people don't trust corporate news because it continually lies to us. Some of us are good at reading between the lines, and finding alternate news sources that actually cite real documents, do real research, and come to sound (if not always popular conclusions, like the war in iraq was based on lies, which you didn't believe when we told you). Some us, are smart enough to know corporate news is lying to us, but don't have the skills to do evidence based research, so they believe Breitbart, etc, outlets that are also funded by global billionaires, but cater to those that hate.
CNN, MSNBC, the NY Times, etc, are not telling the whole truth.
Do you have an Obamacare plan? Do you get a subsidy, and how much are you paying?
1
The empirical truth is that the Republican health care position is an ideology, namely if you don't have the money to take care of your health, you are manifestly a deficient citizen and person and deserve whatever suffering you get. They could not care less about the great masses as they age and fail. They themselves enjoy the GEHA plan with appropriate reductions and full coverage, written into Congressional law. As long as such low character rules the thinking of the government representatives, poor health, early death, needless torment, family anguish are predictable results. There is a reason that European states and Japan are populated by citizens who are happy and live long lives. Governments elsewhere function to assist the lives of the governed and regulate profit-making in the health industries if they subvert that higher purpose.
423
Mitt Romney expressed this best when he said that people do not "take responsibility" for their health care. That was when I realized that he and all wealthy people do not use insurance at all. They just pay cash. So, to him, not having the wealth to eschew insurance is a moral fault.
4
I agree with your last two sentences, but what makes you think today's Dems are any more honest and truly caring than the Republicans? Even Mr Leonhardt pointed out that ACA was basically Mitt Romney's plan, and the Democrats have never mentioned the millions of Americans who couldn't afford ACA to begin with.
1
That is exactly correct. The biggest lie is that the system is fair and everyone has an opportunity to do well, and if things go bad, it's all your fault. And most people believe it. They believe that they can't get a job because they are bad people. They believe that Trump is rich because he is smart, not because he is a pathological liar, and a thief that doesn't pay his bills, or his taxes.
The system is designed to move money from the rest of us to the global 1%. That is why a few thousand people own, literally, half of the world's wealth, even though it is impossible for them to create half of the world's productivity.
The system is designed to move money from the rest of us to the global 1%. That is why a few thousand people own, literally, half of the world's wealth, even though it is impossible for them to create half of the world's productivity.
Quick calculation of the CBO estimated savings: $337 billion / 10 years / 330 million people = $100 per person saved per year. And 24 million more uninsured. YUGE!
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It is yuge, because that money will not be evenly divided among 330 million people, it will all go to the 1%.
1
Here is the problem for Democrats. It cannot simply be about 24 million uninsured. It wasn't enough to motivate real healthcare reform in the Clinton years and it won't be enough to motivate change now.
Roughly 55% of Americans receive employer sponsored health insurance. This is not free for those people and many of them still struggle to pay medical bills. Many of them hear discussions of Obamacare and think, "I pay through the nose for insurance and healthcare, why should others get it for free because they don't work." Boom, Trump voter.
The subsidies for Obamacare are generous, but only for those making up to 4X the federal poverty level ($60,000 /year for a family of 3) and they phase out quickly as a family approaches that $60k limit. So, if I'm self employed, and earning $55,000 for my family of 3, I may get $200-$500 in annual subsidies, but my insurance premiums are upwards of $8,000/year with a deductible that may be as much as $7,000. Or, I can forgo insurance all-together and pay the $1,000+ annual penalty. I don't care about the 24 million uninsured people, I see Obamacare as an albatross on my family. Boom, Trump voter.
As Democrats - we will have to convince people that there are costs to having 24 million uninsured people, real financial costs, and that each individual, both of the hypothetical examples above, pays those costs. We have to convince people why it is worth it to keep Obamacare, or something like it, in place.
Roughly 55% of Americans receive employer sponsored health insurance. This is not free for those people and many of them still struggle to pay medical bills. Many of them hear discussions of Obamacare and think, "I pay through the nose for insurance and healthcare, why should others get it for free because they don't work." Boom, Trump voter.
The subsidies for Obamacare are generous, but only for those making up to 4X the federal poverty level ($60,000 /year for a family of 3) and they phase out quickly as a family approaches that $60k limit. So, if I'm self employed, and earning $55,000 for my family of 3, I may get $200-$500 in annual subsidies, but my insurance premiums are upwards of $8,000/year with a deductible that may be as much as $7,000. Or, I can forgo insurance all-together and pay the $1,000+ annual penalty. I don't care about the 24 million uninsured people, I see Obamacare as an albatross on my family. Boom, Trump voter.
As Democrats - we will have to convince people that there are costs to having 24 million uninsured people, real financial costs, and that each individual, both of the hypothetical examples above, pays those costs. We have to convince people why it is worth it to keep Obamacare, or something like it, in place.
3
Thank you! Good to point out the numbers.
Well put. Ryan et al. are now saying that all the uninsured will have "access" to health care and will have "options" and "choices". Those are their new mantras. But they want to take the money away that makes those options and choices real.
Options beyond your means are not options. A choice you can't afford is no choice.
Their true mantra: Punish the poor for being poor, reward the rich for being rich. Even if they are voted out for it, they figure the rich they gave the tax cuts to will welcome them to their firms with open arms at ten times their congressional salary.
Options beyond your means are not options. A choice you can't afford is no choice.
Their true mantra: Punish the poor for being poor, reward the rich for being rich. Even if they are voted out for it, they figure the rich they gave the tax cuts to will welcome them to their firms with open arms at ten times their congressional salary.
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Yes, when they say "access" they mean you can buy it if you can afford it.
You have access to the Ferrari market. All you need is a few hundred thousand dollars to actually buy one.
You have access to the Ferrari market. All you need is a few hundred thousand dollars to actually buy one.
2
The Gop will take ownership of the world’s worst h/c system in the world’s richest nation which has an equal protection clause and bill of rights. Truly surreal.
The fatal flaw in ACA? It’s based on maintaining insurance/drug profits. This is what we can’t admit ---profit is the 1st condition to be satisfied. Then we get the crumbs.
And the underlying fatal flaw is the belief that democratically elected govt regulations can become threatening to our freedom and well being. But corporations can’t.
This Gop credo is exaggerated out of proportion in our politics and creates the worst inequality and middle class downward mobility among advanced nations. The OECD comparisons of countries confirm this by every yardstick---health, education, job protections, family security, gun safety, retirement.
Obama himself was to the right of EU counterparts. He could have traveled the country giving townhalls and speeches explaining how expanding Medicare for all or the public option would work. He caved. That’s what our democrats do.
The types that wouldn’t cave don’t get elected, and wouldn’t get campaign financing from our biggest donors/lobbyists like the insurance/pharma industries.
Our dems made sure those profits stayed untouched, not daring to suggest govt negotiating prices on behalf of the citizens who elect them, which is common in other democracies.
This fatal flaw is ignored by our pundits.
The fatal flaw in ACA? It’s based on maintaining insurance/drug profits. This is what we can’t admit ---profit is the 1st condition to be satisfied. Then we get the crumbs.
And the underlying fatal flaw is the belief that democratically elected govt regulations can become threatening to our freedom and well being. But corporations can’t.
This Gop credo is exaggerated out of proportion in our politics and creates the worst inequality and middle class downward mobility among advanced nations. The OECD comparisons of countries confirm this by every yardstick---health, education, job protections, family security, gun safety, retirement.
Obama himself was to the right of EU counterparts. He could have traveled the country giving townhalls and speeches explaining how expanding Medicare for all or the public option would work. He caved. That’s what our democrats do.
The types that wouldn’t cave don’t get elected, and wouldn’t get campaign financing from our biggest donors/lobbyists like the insurance/pharma industries.
Our dems made sure those profits stayed untouched, not daring to suggest govt negotiating prices on behalf of the citizens who elect them, which is common in other democracies.
This fatal flaw is ignored by our pundits.
121
got my thumbs-up vote but I disagree about President Obama. I never got the impression he succumbed to pressure or went along reluctantly with anything, particularly health care. He proposed Romney Care and not a public option and it seemed to me (at the time, and still does) that was not a political choice it was a personal preference. I know I should cite other right-wing ideas and neo-liberal proposals that President Obama sponsored or pushed through to support my claim but I guess you're already familiar with them.
1
If the problem was the "greedy insurance companies", the non-profit health care co-ops created along with Obamacare would have lower rates and better coverage. What actually happened is that the majority of those co-ops collected subsidies and then went bankrupt, leaving unpaid bills. Despite over two billion in "loans" (which will never be repaid), 17 of the 23 co-ops have already failed.
A list of the closed co-ops can be found here: http://energycommerce.house.gov/news-center/press-releases/and-then-ther...
A list of the closed co-ops can be found here: http://energycommerce.house.gov/news-center/press-releases/and-then-ther...
1
Kudos! You point out the "Elephant in the living room." Let us hope others learn to grasp this basic position, without which, all else is sound and fury signifying nothing.
How can the people remain blind for so long? What leader will rise up and open their eyes? Few aspire to follow Jesus of Nazareth, Socrates, Mohandas Gandhi, or the Reverend Doctor King. Most, it seems, burn with envy over Billy Tauzin!
How can the people remain blind for so long? What leader will rise up and open their eyes? Few aspire to follow Jesus of Nazareth, Socrates, Mohandas Gandhi, or the Reverend Doctor King. Most, it seems, burn with envy over Billy Tauzin!
The Republicans, flailing around in the health care issue as they are through ignorance and incompetence, will pay the piper in the midterm elections in 2018.
So let them have at it.
Obviously they just "didn't know how complex" the issue really is, after all.
And then they will add fuel to the fire by lowering taxes on the wealthy at the expense of the rest of the electorate - all 95% or 99% of them.
Hammer it all home on TV to the viewing pleasure of TV viewers everywhere. Have at it by way of CNN and MSNBC and late-night shows with well-know commentators and comedians, wherever in TV land they happen to exercise their special talents.
The silver lining will be to watch the entire show as it unfolds ... relentlessly.
Gaining control of the Congress has to be the paramount and ultimate goal.
With strength in numbers a new health plan can be pursued.
We can, at long last, work to attain a Single Payer System or Medicare for All.
This result is the only viable, reliable, and valid outcome for us all.
(Another positive result in having a strength in numbers will be the neutering of Trump. Need I say more re: viable, reliable, and valid outcomes.)
So let them have at it.
Obviously they just "didn't know how complex" the issue really is, after all.
And then they will add fuel to the fire by lowering taxes on the wealthy at the expense of the rest of the electorate - all 95% or 99% of them.
Hammer it all home on TV to the viewing pleasure of TV viewers everywhere. Have at it by way of CNN and MSNBC and late-night shows with well-know commentators and comedians, wherever in TV land they happen to exercise their special talents.
The silver lining will be to watch the entire show as it unfolds ... relentlessly.
Gaining control of the Congress has to be the paramount and ultimate goal.
With strength in numbers a new health plan can be pursued.
We can, at long last, work to attain a Single Payer System or Medicare for All.
This result is the only viable, reliable, and valid outcome for us all.
(Another positive result in having a strength in numbers will be the neutering of Trump. Need I say more re: viable, reliable, and valid outcomes.)
45
Republicans thought that Hillary Clinton would be elected and they could continue to make political hay by opposing her. The plan was pretty clear. Now, they seem to think they have an obligation as well as an opportunity to implement that "agenda."
If things had gone as they expected, they would be passing laws secure in the knowledge that President Clinton would veto them. They would have strengthened their control at state and local levels. People would believe their hype about Republican principles. This is a continuing crisis for what conservatism has become and Republicans are just beginning to realize it.
If things had gone as they expected, they would be passing laws secure in the knowledge that President Clinton would veto them. They would have strengthened their control at state and local levels. People would believe their hype about Republican principles. This is a continuing crisis for what conservatism has become and Republicans are just beginning to realize it.
196
Very well said. Too bad facts and history have so little bearing on today’s Republican party.
57
Democrats are so used to hearing Republicans lie about Barack Obama and what he supposedly did or did not do, we sometimes overlook the significance of a particular, important lie.
David Leonhardt is very perceptive in pointing out how the Republican lie about President Obama’s supposedly shoving his health financing plan down the throats of Congress defines and energizes the G.O.P. opposition to Obamacare and anything remotely resembling it.
The grotesque legislation cobbled together by Republicans over the past two weeks would not have sprung to life, except for The Big Lie spread by conservatives that President Obama never gave input to Republicans on the Affordable Care Act. The exact opposite was true, and Mr. Leonhardt is right that we should talk about the Republican lie more often.
Many Democrats vividly remember complaining seven years ago that President Obama was too timid and accommodating towards Republicans on Capitol Hill about the healthcare financing bill which became Obamacare. Our complaints then were close to the truth.
In retrospect, it would have been better if Mr. Obama had possessed the votes seven years ago to shove a healthcare bill down Republican throats – one with a single-payer system.
David Leonhardt is very perceptive in pointing out how the Republican lie about President Obama’s supposedly shoving his health financing plan down the throats of Congress defines and energizes the G.O.P. opposition to Obamacare and anything remotely resembling it.
The grotesque legislation cobbled together by Republicans over the past two weeks would not have sprung to life, except for The Big Lie spread by conservatives that President Obama never gave input to Republicans on the Affordable Care Act. The exact opposite was true, and Mr. Leonhardt is right that we should talk about the Republican lie more often.
Many Democrats vividly remember complaining seven years ago that President Obama was too timid and accommodating towards Republicans on Capitol Hill about the healthcare financing bill which became Obamacare. Our complaints then were close to the truth.
In retrospect, it would have been better if Mr. Obama had possessed the votes seven years ago to shove a healthcare bill down Republican throats – one with a single-payer system.
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I do not understand the obsession with a single payer. Many countries use the German model (Bismarck Model) that uses multiple private insurance companies with many choices of plans. Insurance I see paid for by employers and individuals, not the government. France, the Netherlands, Switzerland and others use this model and their people are satisfied with their health care systems. Our media has never bothered to make this clear, allowing people to mistakenly believe that the only way to have an effective, lower cost health care system is to do away with private insurance and have the government pay the bills.
One thing to understand, however, is that, unlike here, insurance companies in the German model are not for profit and the government regulates them so that they cannot gouge the sick or kick them off insurance altogether, etc. (as the ACA does here).
Britain has the Beveridge Model, a completely socialized system - the government owns the hospitals, hires the doctors, pays the bills. This is the model our VA system follows. In Canada the government pays the bills but hospitals are mostly private and doctors are in private practices. (And, contrary to what Republicans have been saying, Canadians do not flock to the US for health care. They are happier with their own system than we are with ours.)
Until Americans understand what different health care systems exist and the relative pros and cons of each we cannot have an informed debate about this crucial issue.
One thing to understand, however, is that, unlike here, insurance companies in the German model are not for profit and the government regulates them so that they cannot gouge the sick or kick them off insurance altogether, etc. (as the ACA does here).
Britain has the Beveridge Model, a completely socialized system - the government owns the hospitals, hires the doctors, pays the bills. This is the model our VA system follows. In Canada the government pays the bills but hospitals are mostly private and doctors are in private practices. (And, contrary to what Republicans have been saying, Canadians do not flock to the US for health care. They are happier with their own system than we are with ours.)
Until Americans understand what different health care systems exist and the relative pros and cons of each we cannot have an informed debate about this crucial issue.
26
As I watch myself and neighbors engage in the political process, calling Senators and Representatives, marching, and meeting to resist #45 and Republicans, I regret not doing the same for a single payer system in 2008. We should all take ownership for not participating...
4
Medicare is a great brand. 7 years ago many polls showed 2 to 1 support for a plan like Medicare for All. I believe that if Obama had had the courage to strongly campaign for HR676 and had presented the public with the data, the political pressure would have been enough for its passage.
But since he did not try, since he took it off the table from the get go, we will never know.
But since he did not try, since he took it off the table from the get go, we will never know.
3
The question remains: once Obama realized he wasn't going to get any Republican votes, what would he have had to lose by introducing and promoting single-payer plan?
If the issue is empowering patients, how does that become an argument in favor of the insurance bureaucracy's right to exist?
If the issue is empowering patients, how does that become an argument in favor of the insurance bureaucracy's right to exist?
42
My thoughts exactly! Given the facts on the ground, why not go for broke?
1
We must remember the context in which the ACA was debated and passed. It was 2009-2010. The economy had not yet recovered; the unemployment rate was high. Legislation that would have added to the unemployment rolls the hundreds of thousands of people working for health insurance companies was hardly palatable, and would never have passed - even if those job losses would have been gradual, over a few years. It was not the time for drastic change.
2
It needed 60 votes to pass in the Senate, exactly what the Democrats had. There were some Democratic Senators who stated they absolutely, positively would NOT have voted for a single-payer plan. So, this was not only a compromise hoping to get Republicans on board--it was a compromise so that all the Democrats would vote for it.
3
While there is no doubt that ObamaCare has insured millions of previously uninsured Americans, that unfortunately is just part of the story. ObamaCare, if left alone will collapse. Big insurers are fleeing from markets, and premiums for many are rapidly rising. The formula based on taking money from the young and healthy and giving it to the elderly and sick simply isn't working. Medicare subsidies are set to expire putting a greater burden on the states. So, when you tell us that 24 million people have insurance who didn't have it before, tell us the rest of the story.
5
Dan, I think you meant Medicaid subsidies. And they will last until at least 2022. In fact, 93% of the cost Medicaid expansion in 2014 - 2022 will be covered by the federal government.
And ALL insurance works by taking money from those who are lucky and giving it to those who are not. Also you should consider the fact that the young and healthy will some day be elderly and sick.
And ALL insurance works by taking money from those who are lucky and giving it to those who are not. Also you should consider the fact that the young and healthy will some day be elderly and sick.
6
That's how insurance works. Everyone pays premiums; those who have needs receive benefits. If only those who have needs pay premiums, they are in effect "self-insured," a silly euphemism meaning "uninsured." Obviously the best arrangement would be single-payer, with "premiums" in effect paid by a graduated income tax, but the GOP has done such a good job demonizing that as Socialism that it won't happen for a generation at least.
5
But the model of spreading the costs around to the young and healthy, in order to subsidize older and sicker people, works well in many other countries. And not just in single payer countries like Canada or Great Britain, but also in countries that have public-private mixes similar to the ACA, like France and Germany. These countries spend less for better outcomes. Instead of scrapping a model that actuallly WORKS in many countries, why not study how they have stabilized their markets and imitate?
4
I borrow a phrase, Fatal Invention, from the title of the most important book I have read in the past 10 years (see PS beow Dual citizen).
The phrase "Socialistic Obama Care" was the Fatal Invention of Republicans who knew that employment of this invention could guarantee that the USA will remain the only so-called advanced country that prefers keeping its rich rich while maintaining 2d or 3d world health statistics in important areas.
Very likely, that phrase will continue to serve its appalling function for the first 50 years of the 21st Century.
Only-NeverInSweden.blogspot.com
Dual Citizen US SE
In "Fatal Invention-How Science, Politics, and Big Business Re-Create Race in the (American) Twenty-first Century" Dorothy Roberts, socially black, not African American, race = human, shows how wrong it is for the USA to continue to assign people to "races" each the fatal invention of pretender scientists in the service of a racial order.
The phrase "Socialistic Obama Care" was the Fatal Invention of Republicans who knew that employment of this invention could guarantee that the USA will remain the only so-called advanced country that prefers keeping its rich rich while maintaining 2d or 3d world health statistics in important areas.
Very likely, that phrase will continue to serve its appalling function for the first 50 years of the 21st Century.
Only-NeverInSweden.blogspot.com
Dual Citizen US SE
In "Fatal Invention-How Science, Politics, and Big Business Re-Create Race in the (American) Twenty-first Century" Dorothy Roberts, socially black, not African American, race = human, shows how wrong it is for the USA to continue to assign people to "races" each the fatal invention of pretender scientists in the service of a racial order.
12
Watch the Rust Belt and the Midwest and the South vote for these liars again. Never fails.
67
Mr. Leonhardt: Do you believe that the Republicans believe their own lies? I think that they know they are lying. So which is it? Stupid, or lying.
It is worth noting that the ACA originally included the so-called "public option," but It was dropped from the bill; why, exactly, I do not recall.
It is worth noting that the ACA originally included the so-called "public option," but It was dropped from the bill; why, exactly, I do not recall.
17
Well, specifically, it was because the Senator fron Aetna, Joe Liebermann, said he would never support it, but basically it was because Obama was never willing to mount a campaign for an efficient plan.
During the health care debate I wrote to many Times reporters and editors complaining about their lack of coverage for single payer in general, and HR676 in particular. I wanted data, facts, numbers presented to the public. I wanted articles about the many polls showing overwhelming support for Medicare for All. I gave up after Kevin Sack wrote to me that "Single payer is not news."
BTW I do not support a public option. I believe the insurance companies will find ways to attract the young, the healthy, and the wealthy leaving the older, sicker, poorer to the public option greatly increasing its cost. Also since many people will stick with the private plans offered by their employers, we will still have a lot of private insurance with its huge overhead and compliance costs--about $600 Billion a year.
What is required for a healthcare system to be efficient, to get better results at much less money is that it covers everyone so there is one large pool and the it is run by a single institution like government so it can tackle the difficult problems of overutilization and high cost for procedures. The public option meets neither of these requirements. Its failure would provide much ammunition to those who selfishly favor the status quo.
During the health care debate I wrote to many Times reporters and editors complaining about their lack of coverage for single payer in general, and HR676 in particular. I wanted data, facts, numbers presented to the public. I wanted articles about the many polls showing overwhelming support for Medicare for All. I gave up after Kevin Sack wrote to me that "Single payer is not news."
BTW I do not support a public option. I believe the insurance companies will find ways to attract the young, the healthy, and the wealthy leaving the older, sicker, poorer to the public option greatly increasing its cost. Also since many people will stick with the private plans offered by their employers, we will still have a lot of private insurance with its huge overhead and compliance costs--about $600 Billion a year.
What is required for a healthcare system to be efficient, to get better results at much less money is that it covers everyone so there is one large pool and the it is run by a single institution like government so it can tackle the difficult problems of overutilization and high cost for procedures. The public option meets neither of these requirements. Its failure would provide much ammunition to those who selfishly favor the status quo.
2
In the mistaken calculation that it was costing bi-partisan support, that's why. And see how that worked out?
Obama's big mistake, in historical perspective, will prove to have been, underestimating the malice and cynicism of his opponents.
Obama's big mistake, in historical perspective, will prove to have been, underestimating the malice and cynicism of his opponents.
Public option was too much of a threat to the misery and suffering profiteers known as the health insurance industry. Public option would have put them out of business in short order.
To get away with the Republican's great lies over Obamacare takes more then just telling a lie but also takes million's of people willing to accept a lie even when the lies are obvious.
In many ways the ability of the rightwing to get away with such incredible lies for so long, as well as not coming up with anything approaching an alternative set the stage for Trump. If the rightwing were able to get away with accept such obvious lies about Obamacare for so long, and without presenting any alternative, clearly they were willing to accept the endless, almost unimaginable constant lying of Donald Trump.
You can blame the rightwing; you can blame Trump; you can blame the ,if you like, for this horrible mess, but sometimes, when you come right down to it the real blame is with the people who voted for them.
In many ways the ability of the rightwing to get away with such incredible lies for so long, as well as not coming up with anything approaching an alternative set the stage for Trump. If the rightwing were able to get away with accept such obvious lies about Obamacare for so long, and without presenting any alternative, clearly they were willing to accept the endless, almost unimaginable constant lying of Donald Trump.
You can blame the rightwing; you can blame Trump; you can blame the ,if you like, for this horrible mess, but sometimes, when you come right down to it the real blame is with the people who voted for them.
64
The opposition to ObamaCare, Mr. Leonhardt, has much less than honorable "across the aisle" loyal opposition to the boogeyman of "government control of health markets" (capitalism) than it does in the GOP's hostility to the hue of President Obama's skin tone.
The ACA is only the slightest modification of RomneyCare, the former Massachusetts governor's (and loser to Mr. Obama in the 2012 election) lifting from the extreme-right Heritage Foundation's laboratory. What else can possibly account for the demonstrably rabid Republican opposition?
This inexcusable Ryan plan that Mitch McConnell and their puppet of a president are so all-in on is the clearest transfer of public tax money to the idle rich that it's impossible to mistake their naked intentions. They have successfully over the years, first with McConnell's clarion call of "one-term president" and then to John Boehner's and Eric Kantor's serial attempts at repealing the ACA, laughably attempted to disguise the reason for their hatred of the concept of government-sponsored health care for the poor. What they hated was the black president. What else was there? Cost? Choice? Quality of care? Please!
One concludes that these poor folks, a priori against the very idea of a black president, were easy marks for the GOP's legislative thuggery now being presented to them while completely ignoring the financial windfall to the 1%.
No. 45 is clueless. He's merely, dog-like, on Ryan's and McConnell's wealth transfer leash.
The ACA is only the slightest modification of RomneyCare, the former Massachusetts governor's (and loser to Mr. Obama in the 2012 election) lifting from the extreme-right Heritage Foundation's laboratory. What else can possibly account for the demonstrably rabid Republican opposition?
This inexcusable Ryan plan that Mitch McConnell and their puppet of a president are so all-in on is the clearest transfer of public tax money to the idle rich that it's impossible to mistake their naked intentions. They have successfully over the years, first with McConnell's clarion call of "one-term president" and then to John Boehner's and Eric Kantor's serial attempts at repealing the ACA, laughably attempted to disguise the reason for their hatred of the concept of government-sponsored health care for the poor. What they hated was the black president. What else was there? Cost? Choice? Quality of care? Please!
One concludes that these poor folks, a priori against the very idea of a black president, were easy marks for the GOP's legislative thuggery now being presented to them while completely ignoring the financial windfall to the 1%.
No. 45 is clueless. He's merely, dog-like, on Ryan's and McConnell's wealth transfer leash.
104
Question" why can't the Department of Justice be as independent of Trump as the CBO obviously is?
2
The GOP's problem with Obama wasn't that he was black -- it was that he was a Democrat. They made being black Obama's problem, but it was for their own opportunistic, cynical ends.
3
This is what I have feared right along. I have asked black friends whether the opposition to Obama felt racist to them, and they said yes. It felt racist to me, too, but I have less experience, being white. I think SOME of it was like the opposition to Clinton, a hatred of the other side. But sadly, much of it was about Obama's race, or racial identification, or skin color, or whatever it is that people use to divide us.
So brilliant of Obama to state categorically, that he would support any Republican plan that provided improved coverage for all Americans. But let's not forget that Trump had a plan, and consistently announced that his plan was "beautiful" and so much improved compared to Obama's disaster. Trump began to roll back his promised expectations for the knuckleheads who voted for him by stating that "...health care is complicated." Suffice it to say that the compounding ironies would be hilarious were it not for the fact that these reactionaries want to pass this absurd bill. Had Romney run on the promise that he would improve on Obama's version of his Massachusetts healthcare plan, he might have won the 2012 election. But this version of Republicanism is consistent in its opposition Obama, no matter the cost to the AMerican people.
46
Mr. Leonhardt, the president promised that all Americans would be covered by health insurance, yet "the elderly, poor, sick and middle class", a significant part of the support base for this president, are going to find out just how much he cares about them. That's why he and the Paul Ryan-led GOP have discredited the CBO's report that predicts doom for many Americans needing affordable health insurance in the coming years.
No, Mr. Leonhardt, if the Republicans pass this bill and it fails as predicted, they'll simply blame President Obama for the misery heaped across the land. The president will tweet that this Ryan Uncare Act wasa mess he inherited from the previous administration. The 45th and the Republicans will not own anything that's flawed because they'll simply blame the departed black president for everything that's gone wrong with America.
Denying President Obama bipartisan cover has always been the aim of Republicans, specifically Mitch McConnell and Paul Ryan. Better to throw 24 million Americans under the health care bus than to acknowledge that the ACA, while not perfect, is a lifeline to the very constituency that pushed the GOP nominee over the top last November.
The mid terms are just around the corner and the health care issue will be the major issue for both parties. Republicans, for their disregard for elderly, infirm and disadvantaged Americans, could see their red tide ebb out to sea. If that happens, they'll have no one to blame but themselves.
No, Mr. Leonhardt, if the Republicans pass this bill and it fails as predicted, they'll simply blame President Obama for the misery heaped across the land. The president will tweet that this Ryan Uncare Act wasa mess he inherited from the previous administration. The 45th and the Republicans will not own anything that's flawed because they'll simply blame the departed black president for everything that's gone wrong with America.
Denying President Obama bipartisan cover has always been the aim of Republicans, specifically Mitch McConnell and Paul Ryan. Better to throw 24 million Americans under the health care bus than to acknowledge that the ACA, while not perfect, is a lifeline to the very constituency that pushed the GOP nominee over the top last November.
The mid terms are just around the corner and the health care issue will be the major issue for both parties. Republicans, for their disregard for elderly, infirm and disadvantaged Americans, could see their red tide ebb out to sea. If that happens, they'll have no one to blame but themselves.
45
And you actually believe today's Dems care about "elderly, infirm and disadvantaged Americans"???
1
The Republicans have demonized the ACA for all these years and did not have a better plan. Now they came up with a plan which is much worse than the ACA. They have all these time to come up with something better, yet they so stuck in their ideology that they are willing to risk American people's lives for it. Perhaps the only way out is to begin to think what is good for Americans instead of thinking about how to win the next election.
27
"Obamacare is the bipartisan version of health reform. It accomplishes a liberal end through conservative means and is much closer to the plan conservatives favored a few decades ago than the one liberals did."
There should be a special hall of shame for Mitch McConnell, Paul Ryan, and other obstructionist members of the GOP that decided, for purely partisan purposes, to thwart President Obama. I can only imagine what St Peter will say to each of them on Judgment Day, when their lifework is assessed through the prism of Christian love.
But casting these misfits aside, isn't it ironic that in the end, even a bipartisan approach by a black president couldn't get the enthusiasm for a plan they demanded to replace?
And, replace it they have: with the most expensive and poorest healthcare access possible. If the GOP wished to design a plan to take to Satan for his approval, they couldn't do better than the one Dr. Tom Price defended yesterday.
Not only is it Robin Hood in reverse, it neglects to factor in the tremendous rise in premiums stemming from the "'great uninsured" popping up in the ER and raising costs for everyone.
Our lack of adequate healthcare system is killing us. It's more time to make our case at the ballot box and develop a way to insure every single American, entering into the 21st century. It's really up to the American people if they want to live in a country that values healthcare delivery or not.
Medicare for All.
There should be a special hall of shame for Mitch McConnell, Paul Ryan, and other obstructionist members of the GOP that decided, for purely partisan purposes, to thwart President Obama. I can only imagine what St Peter will say to each of them on Judgment Day, when their lifework is assessed through the prism of Christian love.
But casting these misfits aside, isn't it ironic that in the end, even a bipartisan approach by a black president couldn't get the enthusiasm for a plan they demanded to replace?
And, replace it they have: with the most expensive and poorest healthcare access possible. If the GOP wished to design a plan to take to Satan for his approval, they couldn't do better than the one Dr. Tom Price defended yesterday.
Not only is it Robin Hood in reverse, it neglects to factor in the tremendous rise in premiums stemming from the "'great uninsured" popping up in the ER and raising costs for everyone.
Our lack of adequate healthcare system is killing us. It's more time to make our case at the ballot box and develop a way to insure every single American, entering into the 21st century. It's really up to the American people if they want to live in a country that values healthcare delivery or not.
Medicare for All.
740
" It's really up to the American people if they want to live in a country that values healthcare delivery or not."
If only more people had appreciated the value of their coverage under ACA and voted for the candidate who would have worked to improve it, rather than giving so much political power to the party that wants to dismantle, decrease coverage.
If only more people had appreciated the value of their coverage under ACA and voted for the candidate who would have worked to improve it, rather than giving so much political power to the party that wants to dismantle, decrease coverage.
8
The flawed premise manifestly on display in David’s argument is that you can artificially distort markets to the extent that ObamaCare does and that it can survive while merely “tweaking it” here and there. ObamaCare is a creature of a planned, command economy that Democrats sought to foist on an America whose economy, despite their best efforts, is neither planned nor commanded by anyone … yet – and given current electoral realities may never, thankfully, become one. It was bound to crash and burn as its contradictions played out, as its myriad, poorly-synchronized moving parts started breaking down as was not merely predictable but predicted.
The notion that the ACA represented a conscious intent by Obama and an undivided Democratic Congress to “tack right” is absurd. It was a political decision meant to benefit as many as they could while signing them up as loyal Democratic voters. It encountered determined resistance, largely for its lack of demonstrable sustainability but also because Republicans don’t like entitlements and the immense government intrusion they require to function. Democrats SETTLED for what they could get in a pusillanimous cave to political needs and desires. And in doing so incrementally destroyed themselves as a relevant influence on our collective governance.
The notion that the ACA represented a conscious intent by Obama and an undivided Democratic Congress to “tack right” is absurd. It was a political decision meant to benefit as many as they could while signing them up as loyal Democratic voters. It encountered determined resistance, largely for its lack of demonstrable sustainability but also because Republicans don’t like entitlements and the immense government intrusion they require to function. Democrats SETTLED for what they could get in a pusillanimous cave to political needs and desires. And in doing so incrementally destroyed themselves as a relevant influence on our collective governance.
11
Barack Obama himself, just before his Jan 2009 inaugural, speaking on the unsustainability of our entitlements, stated that “What we have done is kicked this can down the road. We are now at the end of the road and are not in a position to kick it any further. We have to signal seriousness in this by making sure some of the hard decisions are made under my watch, not someone else’s.” Then, he proceeded to ignore his promises to fix the unsustainability of Medicare and Medicaid and simply caved, with Pelosi and Reid, to mere political expediency with a fatally flawed ACA, and did it in the teeth of unanimous Republican rejection.
David’s argument that “Trumpcare” is an artifact fashioned by a Republican Party that has moved too far right that “it no longer supports any plan that covers the uninsured”… is equally absurd. It covers millions of people who without it and without the ACA WOULD be uninsured – it just doesn’t cover enough of them or cover them well-enough. You can’t replace an entitlement once conferred with weaker beer: you must MAKE it better and sustainable, even with something completely different. “Trumpcare” doesn’t do that, and Republicans need to go back to the drawing board and do the hard work of fixing healthcare in America with a program that works.
But the “original lie about ObamaCare” was “'If you like your health care plan, you'll be able to keep your health care plan”, and it was offered not by Republicans but by a Democrat.
David’s argument that “Trumpcare” is an artifact fashioned by a Republican Party that has moved too far right that “it no longer supports any plan that covers the uninsured”… is equally absurd. It covers millions of people who without it and without the ACA WOULD be uninsured – it just doesn’t cover enough of them or cover them well-enough. You can’t replace an entitlement once conferred with weaker beer: you must MAKE it better and sustainable, even with something completely different. “Trumpcare” doesn’t do that, and Republicans need to go back to the drawing board and do the hard work of fixing healthcare in America with a program that works.
But the “original lie about ObamaCare” was “'If you like your health care plan, you'll be able to keep your health care plan”, and it was offered not by Republicans but by a Democrat.
4
Mr. Luettgen's last paragraph is not true.
That falsehood has been repeated over and over again by the GOP.
People who were enrolled before ACA was enacted in a non-conforming plan were allowed by ACA to remain in that non-conforming plan. Insurance companies were allowed to continue to offer that non-conforming plan to people enrolled in that plan before ACA was enacted.
Some insurance companies on their own and not required by ACA decided to stop offering these non-conforming plans to these prior enrollees.
Because of this decision by insurance companies some were forced to choose another doctor.
Prior to ACA insurance companies had forced people to choose other doctors. HMO's had booted doctors who offered too much care. People who developed serious and expensive conditions were also denied coverage.
Strange that conservatives did not complain about that.
That falsehood has been repeated over and over again by the GOP.
People who were enrolled before ACA was enacted in a non-conforming plan were allowed by ACA to remain in that non-conforming plan. Insurance companies were allowed to continue to offer that non-conforming plan to people enrolled in that plan before ACA was enacted.
Some insurance companies on their own and not required by ACA decided to stop offering these non-conforming plans to these prior enrollees.
Because of this decision by insurance companies some were forced to choose another doctor.
Prior to ACA insurance companies had forced people to choose other doctors. HMO's had booted doctors who offered too much care. People who developed serious and expensive conditions were also denied coverage.
Strange that conservatives did not complain about that.
424
I would like to ask Mr. Luettgen the following.
Other countries with government run health care spend about half per capita on health care.
They have as good or better life expectancy and infant mortality results.
People in these countries have not lost freedoms and these countries are still democracies.
May I ask those who believe in "free markets" why they oppose allowing Medicare to negotiate drug prices.
The VA has that right and the VA spends substantially less for the same medications.
Other countries with government run health care spend about half per capita on health care.
They have as good or better life expectancy and infant mortality results.
People in these countries have not lost freedoms and these countries are still democracies.
May I ask those who believe in "free markets" why they oppose allowing Medicare to negotiate drug prices.
The VA has that right and the VA spends substantially less for the same medications.
253
This could turn into a Republican civil war. If there is no repeal, conservatives will likely try to primary the moderates. They can only afford to lose two in the Senate and I think there are four who will vote against a repeal with no replacement. There also seem to be at least four hard core conservatives like Rand Paul who will vote against Ryancare because it is too much like Obamacare. It looks to me as if the Senate is deadlocked on this.
42
Every time a Republican is primaried it's by someone more and more regressively to the right. Hopefully soon, the prospects will be so far to the right they'll fall off the flat Earth they also believe in.
11
I'm pretty sure Republicans like Sen Paul will knuckle under and vote for whatever makes it through the mark-up process. The only hope is for their constituents to demand something else and the pr will be intense and effective to make sure they don't.
6
Surely if republicans were able to sell the lie that repeal Obamacare would be better they could sell the truth of making Obamacare even better by ACTUALLY fixing the high costs AND insuring more people by expanding Medicaid to all 50 States, NOT giving tax cuts to the wealthy and allowing people 55 and older to buy into Medicare. Imagine, Republicans have a real opportunity to HELP their constituents, why are they not doing it?
7
"Insurance markets, in some states, weren't functioning well." Righto. Republicans actively worked to sabotage the ACA causing higher premiums and some insurance companies to exit the system. RSenator Marco Rubio placed an amendment in the must pass spending bill in December of 2015, to reduce support given to insurance companies who lose money by insuring the very sick. That subsidy was cut to 13%, causing companies existed the system and costs rose. He gutted the "risk corridor" also sending rates up for ACA recipients. https://www.nytimes.com/2015/12/10/us/politics/marco-rubio-obamacare-aff...
Cynically many GOP-controlled states rejected the ACA and Medicaid coverage for their citizens or attached punishing conditions to the aMedicaid funds, as Mike Pence did kicking some low-income adults off their Medicaid coverage for six months if they don't pay premiums, and require people to have health savings accounts who couldn’t fund them. http://www.politico.com/story/2016/07/mike-pence-obamacare-225590
Cynically many GOP-controlled states rejected the ACA and Medicaid coverage for their citizens or attached punishing conditions to the aMedicaid funds, as Mike Pence did kicking some low-income adults off their Medicaid coverage for six months if they don't pay premiums, and require people to have health savings accounts who couldn’t fund them. http://www.politico.com/story/2016/07/mike-pence-obamacare-225590
923
Ann, assuming it gets approved, I've posted on GOP sabatoge a couple above this.
To me it's as obvious as a polar bear in your kitchen, and I wonder whether anyone has looked into it.
Everything became Topsy-Turvy. Thee party of personal responsibility is now proudly refusing to purchase health insurance because freedom. Yet when they can't pay for the ER or intensive care, or they declare bankruptcy, that's on the taxpayer's dime.
To me it's as obvious as a polar bear in your kitchen, and I wonder whether anyone has looked into it.
Everything became Topsy-Turvy. Thee party of personal responsibility is now proudly refusing to purchase health insurance because freedom. Yet when they can't pay for the ER or intensive care, or they declare bankruptcy, that's on the taxpayer's dime.
6
I have a thought, let's make all congress people have to buy their insurance on the free market. If it's so great, let them have try at it and get back to us.
7
It's about time we see something written about the actions of Marco Rubio. There has been far too little publicity reminding the public just what it was that sent the ACA on a downward financial spiral. Insurance companies taking on a whole slew of sick people, and not enough healthy people at first, was very expensive. That very support that the insurance companies were to receive in the initial phases was removed before the program even got off the ground, and that's why so many companies had to exit.
14
The irony for the Koch funded tea party is painful. By demanding repeal of the ACA, they have spent 6 years demanding a tax cut for the 1%, at the expense of affordable and accessible heathcare for themselves and everyone they know.
Health care is a human right. Health care should be an American right.
Single Payer Now
Good news - there's hope today in California:
http://www.latimes.com/politics/essential/la-pol-ca-essential-politics-u...