Make no mistake about it. There is nothing "skinny" about removing millions and millions of people from the support they get from their employers for health care, which is rising in costs at astronomically unfair rates. Once again, gullet neck McConnell shows he is a heartless creature from planet X for crafting this idea, and any Republican who votes for it is showing his selfishness (which we already know about) and heartlessness (which we also already know about)
1
The best solution to the health care problem is to completely remove the federal government from health care. From the beginning of the USA in the late 1700s right up until the 1960s the federal government had almost no role in our health care system. The results were that we had an excellent health care system that was inexpensive. This is what the country needs to return to. As soon as the federal government became involved in health care in the 1960s costs began to rise not long after, and service also went down hill over time.
1
No. The conversion of non-profit health insurance companies into rapacious profit-driven centers underpins the bloated healthcare industrial complex.
There's no incentive to hold down costs when you can skim 20-30% or more off the top.
Let's start by letting 55 year olds buy into Medicare with its less than 2% overhead. That in essence is the public option that Joe Lieberman sank back in 2009. Look!
Now you've doubled the choices available to Americans in all 50 states.
I thought Republicans liked choices?
There's no incentive to hold down costs when you can skim 20-30% or more off the top.
Let's start by letting 55 year olds buy into Medicare with its less than 2% overhead. That in essence is the public option that Joe Lieberman sank back in 2009. Look!
Now you've doubled the choices available to Americans in all 50 states.
I thought Republicans liked choices?
This is the Potemkin Bill. A fake placeholder to try to get the mean House Bill through reconciliation.
2
Dear Ms. Sanger-Katz,
Please write an article that lays out for your readers the healthcare benefits Congress has, and what it costs them. Thank you.
Please write an article that lays out for your readers the healthcare benefits Congress has, and what it costs them. Thank you.
3
"There has been a mismatch all along between many of the Republicans’ critiques of current law and the likely outcomes of their reforms." is just a kinder way of saying the same thing Krugman's been saying the whole time and is true: They've been lying through their teeth and they know it.
4
Furthermore, the Republicans, as members of the Senate are, (as are all members of Congress), insulated from these mean and heartless healthcare cutback bills (as they are from numerous laws they lay on us), should they become law. Something needs to be done PRONTO about this ongoing, burning portion of the huge mass of corruption in D.C. Namely, Congress makes and avoids whatever rules it lays on the country. The only person who could even attempt to justify that is Trump's old spokeslady, the clown whose name I have buried, who told us about "alternate facts".
If the GOP can't buy into Medicare for all, then add Medicare as a public option.
The health insurance companies won't like that, but as a taxpayer, I would love to have people other than 65+ crowd in the Medicare risk pool.
The health insurance companies won't like that, but as a taxpayer, I would love to have people other than 65+ crowd in the Medicare risk pool.
6
"The individual mandate is unloved because no one likes being told what to do."
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The individual mandate is also unloved because some of us believe that if something is so much in the public interest that everyone needs to participate, then its funding should be through the tax system, rather than going to private corporations, In other words: a tax-financed single payer system.
-------
The individual mandate is also unloved because some of us believe that if something is so much in the public interest that everyone needs to participate, then its funding should be through the tax system, rather than going to private corporations, In other words: a tax-financed single payer system.
10
Repealing the individual mandate without replacing it with incentives for people to buy health insurance and keep it year-round will result in insurance companies leaving the non-group market. Of course, this is what Republican Senators want - a collapse of the exchanges. What they are under-estimating is that insurance companies have said they are leaving the non-group market, they mean the plans sold on the exchanges and non-exchanges. So, the entire non-group insurance market will disappear.
A consequence of the Republican “skinny” replacement for Obamacare will be many employers not providing insurance. In addition to the obvious savings of not paying for employee insurance, there will be another competitive reason to drop health insurance coverage after both employer and individual mandates are gone. Consider two fast food firms trying to hire minimum wage workers. One employer offers the minimum wage plus some (probably meager) health insurance, that requires some partial payments from the employee. The other employer offers the minimum wage and can tell the prospective employee that since there is no health insurance the employee will not have any premium taken from their pay and that will significantly increase their take-home pay. In this way the employer not providing health insurance actually has an easier time attracting low wage workers.
McConnell will use his bag of tricks to get the Trump Health Care bill passed in the Senate. Already the Senate parliamentarian has conveniently ruled that reconciliation cannot be used in a bill that cuts off funding to Planned Parenthood. That resolves the problem McConnell had with some Senators unwilling to vote for any bill that cuts off funding to Planned Parenthood. The anti-abortion senators can't complain much about the actions of the Senate parliamentarian and will probably thus acquiesce to the bill without it cutting off funding to Planned Parenthood..."
https://seekingalpha.com/article/4090794
McConnell will use his bag of tricks to get the Trump Health Care bill passed in the Senate. Already the Senate parliamentarian has conveniently ruled that reconciliation cannot be used in a bill that cuts off funding to Planned Parenthood. That resolves the problem McConnell had with some Senators unwilling to vote for any bill that cuts off funding to Planned Parenthood. The anti-abortion senators can't complain much about the actions of the Senate parliamentarian and will probably thus acquiesce to the bill without it cutting off funding to Planned Parenthood..."
https://seekingalpha.com/article/4090794
2
Japan's explicit price controls are roughly emulated in other countries via the use monopsonistic systems. Monopsony, meaning "single buyer" is the flip side of monopoly. A monopolist sets prices above free market equilibrium. A monopsonist sets prices below free market equilibrium. It does not matter if there is an actual single payer or many buyers (or payers) whose prices are set by the government or by insurance companies in collusion with each other. More competition among sellers generally leads to lower prices. However, more competition among buyers leads to higher prices. In the health insurance industry the beneficial effects of more insurance companies competing for patients are far outweighed by the adverse effects of insurance companies competing for doctors and hospitals in their HMO plans. This was completely misunderstood during the recent debate on health care reform. With health care, more competition among insurance companies on balance results in higher prices.
Focusing attention on the insurance companies, which are simply intermediaries between the doctors and the patients, was a tragic error. It would like trying to solve a problem of high energy prices by focusing on gasoline stations. Only if the government sets prices can health care prices be controlled. Controlling prices does not automatically result in longer waiting times. Japan generally has shorter waiting times to see doctors than does the USA..."
http://seekingalpha.com/article/1647632
Focusing attention on the insurance companies, which are simply intermediaries between the doctors and the patients, was a tragic error. It would like trying to solve a problem of high energy prices by focusing on gasoline stations. Only if the government sets prices can health care prices be controlled. Controlling prices does not automatically result in longer waiting times. Japan generally has shorter waiting times to see doctors than does the USA..."
http://seekingalpha.com/article/1647632
5
7 years of the GOP's complaining about Obamacare, and now we all see plainly they never had any alternate plan.
If the GOP gets rid of the mandate, Obamacare will fail. Then what, GOP?
If the GOP gets rid of the mandate, Obamacare will fail. Then what, GOP?
1
Right Tibet, bit the ACA is failing WITH the mandate. What to do? H.R. 676 Expanded and Improved Medicare for All. I'm waiting for U.S. journalism to publish, in articles like this, names and amounts of donations politicians get from the medical industries.
Anything is better than nothing. The new GOP speaks...
The “nudge” that currently seems to be in favor in social policy circles is something like auto-enrollment with an opt-out provision. This could be done for Medicaid, or at least letting people know that they’ve been “pre-approved”/may already have qualified.
1
Why do we still insist that everyone have "insurance?" Health insurance serves one purpose only: to siphon money away from health care and into the coffers of for-profit insurers, their investors, and millionaire CEOs. Everyone should have health care. Before there was health insurance there was the doctor-patient relationship. If you could afford the doctor's bill, you paid it. If not, you gave the doctor a dozen eggs, some potatoes, or a nice Christmas gift. The poor were cared for without charge. These days will never come back, of course---medical treatment is super-sophisticated and expensive now. But everyone can still be covered, as shown by the many countries that use a form of Single Payer or similar system. Fair taxation and possibly an additional sales tax could pay for everything. Congress must eventually look at Single Payer, figure out what it would cost, and then calculate the best way to pay for it. Remember, individual insurance premiums would disappear, employers would no longer be required to pay for their employees' insurance, and overall costs would be reduced because of waste reduction and other efficiencies intrinsic to Single Payer. We can do no less for the American people.
11
This is the ONLY sensible approach!
Thanks.
Thanks.
4
Well, of course there is no point arguing over what the Senate bills contain: none of them are about healthcare. All of them are about how best to bamboozle their constituents.
Maybe there is something to learn there about what kind of bamboozle works best in each Senator's district. Dunno if that's useful or just a curiosity.
But bottom line, the Senate GOP has shown they all fall in line but two when McConnell whistles. So vote the bunch out!!! Lackeys, disgraziata, every one!!
Maybe there is something to learn there about what kind of bamboozle works best in each Senator's district. Dunno if that's useful or just a curiosity.
But bottom line, the Senate GOP has shown they all fall in line but two when McConnell whistles. So vote the bunch out!!! Lackeys, disgraziata, every one!!
5
"Without (the nudge of a mandate), the theory goes, mostly sick people buy insurance, and premiums rise to cover that sicker pool." Has anyone really tested this theory? Because it seems to me that smart, healthy people would buy insurance, especially if there is a waiting period to buy insurance, meaning you would be stranded without insurance if you DID get sick.
I''m sure there are a lot of healthy people who will buy health insurance. The concern is a catastrophic illness like cancer, or a terrible accident. I would think healthy people would buy high deductible, low cost plans thinking they can cover their routine costs out of pocket.
But when I read that older people could be charged 5x the cost that younger people would pay for insurance premiums under the GOP plan, I thought to myself there's no way I'd pay that kind of tariff if I were a healthy 60 year old! What a ripoff! Especially if you consider there are plenty of obese, diabetic, and drug-addicted 30 year olds. It seems so unfair! I'd just "self-insure".
The only drawback to self-insuring is: You get bilked by the providers because you can be charged whatever they want to charge you (instead of a negotiated rate). But I suppose the antidote to that is seeking healthcare in some other country where it's a fraction of the cost in the US. And for every story about someone who encounters problems doing that, there are dozens of success stories, so perhaps it's the same success ratio as in the US.
Alternatively, older healthy people can move to Europe or South America.
Seems a shame that the US can't figure out how to make healthcare universal. So much time wasted on this! So much complexity for everyone! All these separate exchanges, computer systems, and insurers! So much fine print (and more to come it seems).
But when I read that older people could be charged 5x the cost that younger people would pay for insurance premiums under the GOP plan, I thought to myself there's no way I'd pay that kind of tariff if I were a healthy 60 year old! What a ripoff! Especially if you consider there are plenty of obese, diabetic, and drug-addicted 30 year olds. It seems so unfair! I'd just "self-insure".
The only drawback to self-insuring is: You get bilked by the providers because you can be charged whatever they want to charge you (instead of a negotiated rate). But I suppose the antidote to that is seeking healthcare in some other country where it's a fraction of the cost in the US. And for every story about someone who encounters problems doing that, there are dozens of success stories, so perhaps it's the same success ratio as in the US.
Alternatively, older healthy people can move to Europe or South America.
Seems a shame that the US can't figure out how to make healthcare universal. So much time wasted on this! So much complexity for everyone! All these separate exchanges, computer systems, and insurers! So much fine print (and more to come it seems).
1
The point of health care is shifting from what benefits people most in need of care to what one party, one person wants. Wants of the wealthy few over needs of the many without wealth. Such a proposed deal. How can the Republican senators and representatives let this happen, be a party to this? What a sad party they are. Sad. Sad president too. Sad.
3
Who is going to make it clear to people who decline to purchase health insurance on the "skinny plan" that they will be on the hook for 100% of the cost of their care if they have an accident (that they can't sue someone else to cover) or get sick? And at "list price" (or whatever they can talk their provider down to) since they won't have a payer's negotiated usual and customary price?
If the GOP is willing to let people go without, or buy cheaper plans with loopholes, then they need to ensure buyers fully understand the risks -- that no one is going to bail them out if they get stuck. I'm sure not willing to subsidize a young person who blows off insurance only to drive their mountain bike over a cliff and rack up big bills.
Why aren't the Dems asking questions like this? Not to mention that none of us can actually predict our future needs.
And when will we finally have a substantive discussion about how to lower total healthcare costs -- instead of just arguing about who funds what and how?
If the GOP is willing to let people go without, or buy cheaper plans with loopholes, then they need to ensure buyers fully understand the risks -- that no one is going to bail them out if they get stuck. I'm sure not willing to subsidize a young person who blows off insurance only to drive their mountain bike over a cliff and rack up big bills.
Why aren't the Dems asking questions like this? Not to mention that none of us can actually predict our future needs.
And when will we finally have a substantive discussion about how to lower total healthcare costs -- instead of just arguing about who funds what and how?
2
With Single Payer, that young biker will be covered whether he likes it or not. Everyone is covered--everyone pays (if they are able). No one should have to bear responsibility for the irresponsible. But for years we have borne the cost of care for alcoholics with severe liver disease, smokers with COPD and lung cancer, even overeaters with diabetes. We are all in this together. Single Payer plans would encourage healthy lifestyles, early detection of illness, screening for high BP, e.g. Years aago, in British Columbia, the government tried to limit health coverage to "acts of God" only, excluding illness caused by unhealthy habits. It failed. Gradually, as wikth smoking, "bad habits" will decrease with knowledge and by taxing to the point where the habit is discouraged. Easy to theorize...drug addiction makes it harder.
5
Exactly! We are singing the same tune. We need single payer!
The notion that choice (whether or not to buy insurance, what plan to buy) is good is flawed. None of us can predict the future. And, as you point out, many people act irresponsibly. What are we going to do, throw them in the street? The GOP isn’t addressing the “what if” you don’t choose to insure yourself, then disaster strikes?
Sooner or later, all of us will need some sort of significant healthcare. If we all pay in, all of our lives, we will amortize the costs. Sure, some of us will use less and pay for a lot more than we used over our lifetime. But our society as a whole will be healthier and more productive, and happier. And gone will be all the complexity and anxiety.
We need a single-payer system to lower total costs and improve overall outcomes -- via leverage on prices (usual and customary charges, fair drug prices), influence on how care $ are spent (increased the emphasis on wellness and prevention, reduced fraud and waste), elimination of the 25% “tax” we currently pay (profit and overhead at insurers).
Why can't the Senate discuss this? Instead of the huge time-waste on these DOA bills that will just destroy people's lives, job mobility, peace of mind... and add additional layers of complexity that just tie everyone in knots.
The notion that choice (whether or not to buy insurance, what plan to buy) is good is flawed. None of us can predict the future. And, as you point out, many people act irresponsibly. What are we going to do, throw them in the street? The GOP isn’t addressing the “what if” you don’t choose to insure yourself, then disaster strikes?
Sooner or later, all of us will need some sort of significant healthcare. If we all pay in, all of our lives, we will amortize the costs. Sure, some of us will use less and pay for a lot more than we used over our lifetime. But our society as a whole will be healthier and more productive, and happier. And gone will be all the complexity and anxiety.
We need a single-payer system to lower total costs and improve overall outcomes -- via leverage on prices (usual and customary charges, fair drug prices), influence on how care $ are spent (increased the emphasis on wellness and prevention, reduced fraud and waste), elimination of the 25% “tax” we currently pay (profit and overhead at insurers).
Why can't the Senate discuss this? Instead of the huge time-waste on these DOA bills that will just destroy people's lives, job mobility, peace of mind... and add additional layers of complexity that just tie everyone in knots.
1
In considering the bigger picture, no sentient senator or representative would ever vote for any of the options that now appear to be in Mitch McConnell's infernal political bake-oven. Sadly, consideration of the big picture requires dispassionate thought, and congressional thoughtfulness on the GOP side is an oxymoron, save for the two women Republican who, alone among their GOP colleagues (including you Senator McCain, have the pebbles to take a stand for the people who elected them to office.
3
Heathcare service is like police service and firefighter service. It is there to protect Americans from harm to life and liberty and to empower them in their pursuit of happiness. It supports our declaration that all Americans are created equal.
Required Results of New Healthcare Act:
One: Expand the number of people covered.
Two: Do not reduce the benefits of any person now eligible.
Three: Do not increase the costs to any person now covered.
Four: Pre-existing conditions covered.
Five: U. S. Government to negotiate drug, device, and service prices.
Six: U.S. Government to allow purchasing drugs and devices from foreign sources.
Seven: Companies that drop participation are not allowed to have any U.S. Government business. https://www.theatlantic.com/health/archive/2017/05/why-so-many-insurers-...
Eight: Elected officials have the same coverage as ordinary Americans.
Nine: Preventive Life Style screenings with first visit of a calendar year
Ten: No restrictions of funding for Planned Parenthood
Eleven: Better policy on the disposition of “expired”, but still safe and effective drugs.
One approach would be Medicare/ Medicaid for all Americans.
Required Results of New Healthcare Act:
One: Expand the number of people covered.
Two: Do not reduce the benefits of any person now eligible.
Three: Do not increase the costs to any person now covered.
Four: Pre-existing conditions covered.
Five: U. S. Government to negotiate drug, device, and service prices.
Six: U.S. Government to allow purchasing drugs and devices from foreign sources.
Seven: Companies that drop participation are not allowed to have any U.S. Government business. https://www.theatlantic.com/health/archive/2017/05/why-so-many-insurers-...
Eight: Elected officials have the same coverage as ordinary Americans.
Nine: Preventive Life Style screenings with first visit of a calendar year
Ten: No restrictions of funding for Planned Parenthood
Eleven: Better policy on the disposition of “expired”, but still safe and effective drugs.
One approach would be Medicare/ Medicaid for all Americans.
7
The notion that you can pick and choose the items you like in Obamacare and discard the rest is the equivalent of telling you you can continue your hyper consumption of sugars and not worry about diabetes.
Naturally, that's a message that appeals to the gullible and uninformed: i.e., Republicans.
Naturally, that's a message that appeals to the gullible and uninformed: i.e., Republicans.
2
It appears that President Trump is not the only politician in Washington who does not understand health care, more specifically health insurance. In their effort to end the "nightmare of Obamacare," repealing the individual mandate, thus removing a financial incentive for healthy people to purchase health insurance, will only make health insurance MORE expensive in the individual marketplace and also less available as the number of healthy patients in the marketplace shrinks. Correct me if I am wrong, but I thought the "nightmare" was the high cost of health insurance and low availability in the individual marketplace. Did I miss something here? (heavy sarcasm intended)
3
How can the Senate Republicans be so short-sighted! Without having "healthy" people participate the pool of insured becomes smaller and the costs increase for those who want and need to have insurance. Those who do not participate and become ill or suffer an accident will get care for which all the others must pay; it is that simple. There is no free lunch. Also, let's stop calling the ACA Obamacare. President Obama did the best he could with a Congress that balked at every move he and the Democrats made. It is time to stop cow-towing to Mr. Trump and make the changes to the ACA that will make it better. By repealing the ACA we will set healthcare insurance back, not forward.
9
The employer mandate isn't just about "paperwork". It requires employers to offer coverage of a certain standard, cover way more people than they would otherwise, especially smaller employers, and facilitated the change of "full time" from 40 hours down to 30 hours.
Making the threat of that fine go away will allow businesses to reduce their healthcare offers and the quality of coverage significantly.
Need to know that.
WR
Making the threat of that fine go away will allow businesses to reduce their healthcare offers and the quality of coverage significantly.
Need to know that.
WR
4
This would be terrible legislation, but I find myself almost wishing they pass it. Trump would otherwise sabotage the ACA anyway, and with this law in place at least it can't be blamed on the Democrats.
2
The "skinny" is probably what Republicans will end up with to "let Obamacare fail". It exacerbates problems with the health insurance markets and Republicans will blame those problems on Dems. Single-payer is the only solution but the body politic isn't ready for it even if 50 million, give or take, actual bodies are.
4
It bears repeating in well documented detail, but the essential fact is simple. Republican leaders are quite evil and utterly dishonest.
5
And what about Trump's promises?
PRESIDENT TRUMP: “It's going to be -- what my plan is is that I wanna take care of everybody. I'm not gonna leave the lower 20 percent that can't afford insurance.” And, PRESIDENT TRUMP: “... here's what I can assure you, we are going to have a better plan, much better health care, much better service treatment, a plan where you can have access to the doctor that you want and the plan that you want. We're gonna have a much better health care plan at much less money.”
ABC News David Muir interview 1/25/17
PRESIDENT TRUMP: “It's going to be -- what my plan is is that I wanna take care of everybody. I'm not gonna leave the lower 20 percent that can't afford insurance.” And, PRESIDENT TRUMP: “... here's what I can assure you, we are going to have a better plan, much better health care, much better service treatment, a plan where you can have access to the doctor that you want and the plan that you want. We're gonna have a much better health care plan at much less money.”
ABC News David Muir interview 1/25/17
11
This should be cut, copied, and pasted in response to every Tweet he tweets.
6
This should be called the "Republicans Don't Care" bill. They obviously don't care about people with pre-existing conditions, for without the individual mandate healthy people will opt out of the Obamacare market, leaving only sick people behind. In such a market insurers will jack up prices or simply stop offering insurance to those with pre-existing conditions.
And no, risk pools for the sick don't work.
And no, risk pools for the sick don't work.
7
It all started on this downward spiral after Nixon proposed a law allowing for profit healthcare to help his friend Kaiser. That was in 1973. Before that time insurance companies were 'mutual' companies. The premium payers were the shareholders and any profits generated by the company's activities went back to them. After 1973 the for profit insurance industry emerged and the CEOs of the then dominant Blue Cross/Blue Shield companies, who prior to that time were pretty well paid, became millionaires. And insurance companies started to be owned by outside shareholders. This means that the company now has to answer to those shareholders and they expect ROI. These days we have hedge funds buying and controlling healthcare services and they really double down on ROI. (return on investment) The people who now own and control healthcare do not care who gets covered or who doesn't, they just expect their returns. And it is not a huge industry with literally millions of people involved and that is what is both wrong with it and why it's such a battle to change. To have any idea on how to move forward you have to have some idea as to how we came to where we are. And as to who is involved.
10
It is not the Republicans job to care about the poor or the middle class in the United States. The GOP is not the parents of the poor or middle class. In fact; it is not the job of the Democrats or Republicans to take care of the poor or middle class. That job belongs to the families friends, neighbors, and local governments of poor and middle class citizens in America
In that case, it's not the job of the poor and middle class to vote for Republicans.
13
It is the job of elected officials to decide what their job consists of as long as it's consistent with the principles outlined in the constitution. It is your privledge as a citizen to express your disapproval if you disagree with their decision. It is their right as elected officials to ignore your uninformed opinion.
7
I have an informed opinion. The GOP just doesn't want to listen to my opinion. And for whoever it was who said that it wasn't the job of the government to take care of sick people, he/she is wrong. The government makes the decisions, as I recall. And those who are fortunate enough to work and have insurance for themselves and their children, great. It was William Spear who made that comment and I notice that no one agreed or recommended it. That ought to tell you something, Mr. Spear. I am disabled, by the way, and do you think I am NOT worried? Yes, I am. I have twin adult children who I raised alone. I've never asked them for money and will not do so. So, Mr. Spear, would you care to help me out. Just send me a message and I will send you my address and you can overnight me a check. I would appreciate that from a private citizen. Thank you.
8
It's like they are trying to decide how much to kill us.
9
i honestly no longer understand what kind of reality the gop "leadership" is in and their craven desire to do so much harm to so many people.
for a bunch of "leaders" who have just railed against the aca, they have a shockingly poor answer for it. given all the time they've spent on this (7 years) you'd think they had a plan in their back pocket...
one last point about the gop.... meet you're elected death panel. people will surely die as a result of their decisions. not only should they be ashamed of themselves, they should be held criminally liable for these deaths.
for a bunch of "leaders" who have just railed against the aca, they have a shockingly poor answer for it. given all the time they've spent on this (7 years) you'd think they had a plan in their back pocket...
one last point about the gop.... meet you're elected death panel. people will surely die as a result of their decisions. not only should they be ashamed of themselves, they should be held criminally liable for these deaths.
13
passing a bill is a win win, no health insurance for all those who got is a win win the GOP wins and everyone who loses there insurance will laud the GOP for saving them from Obama the Horrible and vote Republican again , yay !
2
Seems that the Republicans has no health policy at that other than passing any bill that includes the words "Repeal Obamacare"
11
Still looking for a "win" instead of making good policy. The GOP must start telling its followers that the ACA has proven the Heritage Foundation model was correct and, though the party wanted something different back in 2010, today the states should move now to expand Medicaid and Congress should address a few other issues that create imbalance.
Sell it this way: The GOP didn't change its stance, it instead got more and better information and will act on that information in the interest of the American people.
Sell it this way: The GOP didn't change its stance, it instead got more and better information and will act on that information in the interest of the American people.
15
If they do the skinny repeal it will be one more step towards single payer. By whatever means necessary
8
Better to build to Single Payer from ACA. That way we avoid all the unnecessary DEATHS.
5
"Those provisions are unloved." Unloved by whom? That's a mighty big assumption. I don't care if employers and manufacturers of medical devices are taxed, and I would even pay a small tax. My feeling is that the wealthy few who are bankrolling Trump and the Tea Party are the only people who don't like the taxes. And even 50% of Trump voters would be happy with required insurance if the premiums were lower. The myth that more than perhaps 25% of Americans want Obabamacare is the constantly repeated Big Lie.
5
Horrified that McCain voted with the Fascist/ Republicans. Americans do not deserve what these evil people are doing. We are the electorate and should have the health insurance WE want not what these foul minded cheats want. They are the devil incarnate while ALL Western Europeans have good health insurance. Big money, Koch brothers and a disgusting pagan sinful president have ruined our country.
16
So a high end insurance user due to brain cancer, whose treatment I will help pay for, makes a dramatic appearance to endorse the end of health insurance for millions of Americans, including myself. The hypocrisy is stunning; of course I'll fall on your sword for you.
19
And if you developed cancer, or had a sudden crippling stroke - as my spouse did at age 50 - I have no issue with paying for healthcare insurance, especially single-payer comes into existence, even for you. That's how insurance works.
1
It's ok for the GOP to break promises to the "bottom" 90%/ they don't work for those folks in the first place. Just as long as they don't break the promise to lower taxes on the unearned income.
16
Shame on John McCain for flying across the country to vote to open debate on a mean, nasty bill. Senator McCain, having cancer doesn't make you a hero. Stopping this awful healthcare would have been a heroic move. You did the wrong thing. This vote and inflicting Sarah Palin on the country will be your legacy.
35
In other words, the content of the bill is irrelevant as long as Republicans can get the necessary votes to pass it. What a disgrace. What a charade. A fake bill to stroke a fake President.
23
A Maverick in Name Only. A Republican when the chips are down.
Disgusting and dishonorable, SIR.
Disgusting and dishonorable, SIR.
15
Premiums and co-pays will go up if this despicable "skinny" repeal is passed. That applies to the middle class Trump supporters as well and they don't even realize it! The GOP doesn't care about the American people unless they are the rich 1%. The Dems need to stand firm on "single payer". If this GOP bill passes---let the GOP be blamed this time around and hopefully the mid-terms will change the landscape of Congress and Governors and we can start going forward again instead of backwards.
10
As described here, the skinny repeal would be a big fat mistake.
17
Well it certainly warrants open, hearty, bipartisan debate that is visible to the public!!!! (Isn't such DEBATE what got approved today? )
Maybe a dumb question. I thought the Senate Republicans were trying to use the procedure "reconciliation" so that they would only need 51 votes to deal with budget-related issues. How can they use that for a "skinny repeal" which seems to apply to regulations (e.g the mandates), with the budget considerations being incidental (i.e. the mandates aren't making the Federal government a ton of money). Wouldn't they need 60 votes for those?
13
Promises, promoses, what about Trump saying everyone will be covered on 60 Minutes???
12
Of course they are.
Skinny Obamacare would be like auto insurance if people only bought it after they had an accident.
11
Republican ill-devised efforts to repeal Obamacare are a sham to avoid being called incompetent and spiteful, even racist, as they do not offer anything better, actually much worse if the individual mandate is thrashed. Basically, the republicans have no idea what they are doing. Neither our ignoramus in chief. The democrats ought to adopt bravery, for a change, and propose the best solution already in place in Europe, Canada and Australia, a single payer universal healthcare system. Too bad McCain had to prove he too is a coward and a hypocrite, denying basic health coverage...while he 'enjoys' the full "enchilada".
10
McCain has been covered by Government funded Healthcare, since Birth.
Literally. Hypocrisy, much???
Literally. Hypocrisy, much???
17
Today's events sicken. One who has insurance or no financial limitations might just want the Republicans to enact their "repeal" and whatever version of "replace" they settle on now, rather than later, so that the misery will be apparent at the next election. But of course, millions would suffer and so the strategy in untenable. Who could vote just to "win" at such a cost?
Oh, wait, the Trump-Pence-Ryan-McConnell Republican Party just did.
Oh, wait, the Trump-Pence-Ryan-McConnell Republican Party just did.
10
Trump is still calling Obama a liar after Health Insurers did every thing possible to destroy Obamacare. Every CEO of every Health Insurance Company is a REPUBLICAN.
UnitedHealth CEO Stephen Hemsley was paid $102M in '09, and so many more millions and millions each year thereafter. So who here believes that compensation is because the largest Health Insurer is going broke? Trump wasn't this CEO to have a Tax Break...
Americans suffer rising insurance rates, Republican CEO's are out to enrich themselves at the expense of Americans, and Trump wants the CEO's to have a HUGE tax break, while cutting back health insurance. Republicans love this ... it is kinda fun to watch.
UnitedHealth CEO Stephen Hemsley was paid $102M in '09, and so many more millions and millions each year thereafter. So who here believes that compensation is because the largest Health Insurer is going broke? Trump wasn't this CEO to have a Tax Break...
Americans suffer rising insurance rates, Republican CEO's are out to enrich themselves at the expense of Americans, and Trump wants the CEO's to have a HUGE tax break, while cutting back health insurance. Republicans love this ... it is kinda fun to watch.
6
Repeal and Replace the GOP.
18
I am glad that to get a scoop on this repeal drumbeat the Dems have come out with a plan to combat rising pharmaceutical prices. They are demanding pricing transparency and the need for companies to get permission for big increases. Wooow! That will turn some heads! They have put their hand on the pulse of the nation. There was a Kaiser 2015 poll showing that this is an extremely important issue across the political spectrum. In fact, even Republicans cared more about doing something about the price of drugs than cared about repealing the ACA. Maybe Republican voters erroneously think the GOP is going to do something about drug prices. Lol. They'll be worse. Helllooo donut hole. Trump spoke about drug prices but spinelessly caved when he met the Pharma execs, who are now enjoying tax "incentives". Let's see if there are any amendments about this or importing meds or reforming patents or allowing Medicare to negotiate the price of meds. Hmm. Alternate universe: If the GOP is looking to increase popularity they could allow measures like these. They could grab the credit.
5
Glad the Republicans have made it a priority that their friends in the medical device business will get a break. Ironically they probably sold more of those devices the past few years under Obamacare.
8
"The individual mandate is unloved because no one likes being told what to do."
Really? Have Americans become so comfortably soft and accustomed to their "freedoms", (Wisconsin Republican Senator Ron Johnson's terminology) that they can't be asked to do anything that would help their fellow Americans.
Tell that to my Dad, a Navy WWII pilot who lined up in a line of volunteers a block long Monday, December 8, 1941, or my uncle shot down B17 over Hanover, Germany 1944, shot in the arm when he parachuted in, POW. Only 2 out of the 10 boys made it home alive, or my brother Tom, shot down (Huey) and killed, age 24, 18 month old son, in the An Khe pass, Vietnam. He volunteered for the mission which was listed as very dangerous that day. Senator John McCain was a POW himself then. Tom was trying to help Sen. McCain win his freedom then, but John never knew it. My family members never thought of themselves, and didn't "have to be told what to do." They did their duty honorably in hope that their fellow Americans could have better lives.
My point is self-explanatory I trust.
Really? Have Americans become so comfortably soft and accustomed to their "freedoms", (Wisconsin Republican Senator Ron Johnson's terminology) that they can't be asked to do anything that would help their fellow Americans.
Tell that to my Dad, a Navy WWII pilot who lined up in a line of volunteers a block long Monday, December 8, 1941, or my uncle shot down B17 over Hanover, Germany 1944, shot in the arm when he parachuted in, POW. Only 2 out of the 10 boys made it home alive, or my brother Tom, shot down (Huey) and killed, age 24, 18 month old son, in the An Khe pass, Vietnam. He volunteered for the mission which was listed as very dangerous that day. Senator John McCain was a POW himself then. Tom was trying to help Sen. McCain win his freedom then, but John never knew it. My family members never thought of themselves, and didn't "have to be told what to do." They did their duty honorably in hope that their fellow Americans could have better lives.
My point is self-explanatory I trust.
19
The Republicans are determined to kill Obamacare without taking the blame for doing so. The "skinny repeal" is clearly designed to drive all the insurers out of the Exchange Market -- they would have to flee, it would be impossible to make money if all the sickest but only the sickest buy insurance.
Let's be clear, every Republican who voted "yes" today voted to drive a stake in the heart of the current health insurance system and, at the same time, no Republican has a replacement that his/her party will accept. So they are killing the known without a Plan B. Americans will die, Americans will go bankrupt and Americans will suffer due to this vile action.
Let's be clear, every Republican who voted "yes" today voted to drive a stake in the heart of the current health insurance system and, at the same time, no Republican has a replacement that his/her party will accept. So they are killing the known without a Plan B. Americans will die, Americans will go bankrupt and Americans will suffer due to this vile action.
10
Call this the "only rich sick people can buy health insurance" plan. In this facile dodge from real governing, there must be one more provision, one I am sure Republicans will not have the honesty or guts to add. Along with removing the individual and employer mandates, Republicans need to remove the mandate requiring free-riders be treated by hospital EDs. Republicans need to remove the current requirement that EDs "stabilize" any sick person, regardless of ability to pay. If someone shows up without cash, credit cards, or proof of insurance, the hospitals must be legally protected to allow you to bleed out on the sidewalk. Free riders 'need to have some skin in the game' or Republican's "skinny repeal" is nothing but a slap in the face to the health care industry, and another lie to the American people. Its not "cheaper", its not "better", its not "covering everybody", its not "lowering medical costs" -- all these Republican plans are lies, through and through... Time for Republicans to abandon the lies and tell the American people the truth: Republicans don't care about the American people's health, Republicans don't care about the American people's financial situation - they just want to cut the safety net for everyone who is poor or sick, everyone who needs help. Put most fundamentally, Republicans just don't care about the poor, the working class, and middle class people.
9
Another words, it's just a stupid exercise in hypocrisy and racism, led by Southern Senator McConnell. What a waste of time. I do hope Senator McCain enjoys his excellent coverage and heals quickly, is that he will be able to enjoy the mess he helped create.
4
What bothers me is all the time congress is wasting. It's clear we need a universal single payer healthcare plan for all. I'm even willing to settle for ideas that get us there in stages. Instead we are getting these ridiculous bills designed to hurt Americans more. Why? Just so Trump and a hand full of republicans can save face? Someone wake me up when this nightmare is over.
9
Ok, so I'm Dutch and I'm puzzled about this. In the Netherlands we have a system reasonably similar to the ACA (individual mandate, private insurance companies, basic requirements on coverage, etc.) with one important difference. In the Netherlands everyone is insured privately through the equivalent of the marketplaces. So no insurance through employers. Which means that the pool is huge (effectively the entire population), consumers have a choice (effectively all insurance plans and companies) and businesses don't have to deal with the administrative overhead. Insurance costs approximately 115 dollars per person per month (with a 450 dollar deductable maximum per year). Now please explain why that would not work in the US just fine too?
16
We have 50 states who think what's good for Joe in Maine is not good for Joe in Idaho. Rank stupidity when it comes to things like healthcare, education, air and water quality, etc. why not have 50 armies and navies? Exactly!
5
So what about the "be without insurance for two months and you can't qualify to get it for six" plan?
That really is coaxing the individual mandate, isn't it? At least the mandate was straight forward and if you got cancer, or some unforeseen ailment, you were covered if you abided by the legislation, plus many preventative options.
The new proposal just seems cruel. When people get caught in between those months, and diagnosed, they will have a huge expense, that they more than likely will not be able to afford.
That really is coaxing the individual mandate, isn't it? At least the mandate was straight forward and if you got cancer, or some unforeseen ailment, you were covered if you abided by the legislation, plus many preventative options.
The new proposal just seems cruel. When people get caught in between those months, and diagnosed, they will have a huge expense, that they more than likely will not be able to afford.
5
Great explanation by Margot Sanger-Katz. It seems that McConnell would just duplicate what was there before ACA, but his bill would be even more costly.
It costs to remove the individual mandate *and* eliminate discrimination against preconditions. So McConnell might eliminate the mandate that insurers accept people with existing health conditions. Also, it costs money to carry people on health care between jobs. McConnell should eliminate that as well. So we'll have what we had before.
But before, uncovered people were getting treated in emergency rooms and driving up insurance costs to pay for their care. Those who had health insurance paid more to cover them. As this number increases, insurance costs will rise further under the McConnell bill
Republicans have failed miserably with this bill. John McCain is absolutely right, this bill needs to be thought carefully in a bipartisan way that supports its success, unlike what Republicans are doing now. But McCain didn't mention the loose cannon on deck that is overseeing the requirements.
The Republican healthcare bill is in such a mess because of the lack of leadership from the White House.
It costs to remove the individual mandate *and* eliminate discrimination against preconditions. So McConnell might eliminate the mandate that insurers accept people with existing health conditions. Also, it costs money to carry people on health care between jobs. McConnell should eliminate that as well. So we'll have what we had before.
But before, uncovered people were getting treated in emergency rooms and driving up insurance costs to pay for their care. Those who had health insurance paid more to cover them. As this number increases, insurance costs will rise further under the McConnell bill
Republicans have failed miserably with this bill. John McCain is absolutely right, this bill needs to be thought carefully in a bipartisan way that supports its success, unlike what Republicans are doing now. But McCain didn't mention the loose cannon on deck that is overseeing the requirements.
The Republican healthcare bill is in such a mess because of the lack of leadership from the White House.
2
Skinny repeal would be a self inflicted gunshot wound for the GOP. In one stroke they would take full ownership of any and all problems with the healthcare system while at the same time destabilizing it.
From there on out, people will blame Trump and the GOP for every price hike and insurance headache just like Obama was blamed for the past seven years. It's a steep price to pay to accomplish so little.
From there on out, people will blame Trump and the GOP for every price hike and insurance headache just like Obama was blamed for the past seven years. It's a steep price to pay to accomplish so little.
9
This is how insurance is supposed to work. Say you own a car, all 50 sates require you to have insurance at the very minimum liability insurance. If you're driving along and you get pulled over, and you have no insurance what happens, oh, right you get a ticket. That ticket, levies a fine, that is collected by a mechanism call the courts.
Healthcare would work the same way. Everyone participates, or your fined. So would follow that healthcare would work the same, and because the IRS, is the "collector of the fines" i.e. a ticket for NOT having insurance. When everyone participates it lowers premiums. It is not a tax because the IRS collects the fine, the government doesn't have police to issue healthcare tickets, and no courts to levy and collect the fine. So it's not a tax, since a tax by definition is collected through out the year, by the way, how does the Senate "fine" for not having health insurance the previous 6 months not a tax, if we were to follow the GOP's assertion that the fine is a tax (it isn't). The senate could lower the restriction of selling over state lines, that would help too but taking insurance away from 20 million plus, will have its consequences in 2018 and in 2020.
Healthcare would work the same way. Everyone participates, or your fined. So would follow that healthcare would work the same, and because the IRS, is the "collector of the fines" i.e. a ticket for NOT having insurance. When everyone participates it lowers premiums. It is not a tax because the IRS collects the fine, the government doesn't have police to issue healthcare tickets, and no courts to levy and collect the fine. So it's not a tax, since a tax by definition is collected through out the year, by the way, how does the Senate "fine" for not having health insurance the previous 6 months not a tax, if we were to follow the GOP's assertion that the fine is a tax (it isn't). The senate could lower the restriction of selling over state lines, that would help too but taking insurance away from 20 million plus, will have its consequences in 2018 and in 2020.
10
The skinny option has merit in that it opens the door to a more comprehensive reform of existing health care law. Hopefully Democrats and Republicans could compromise. Republicans would get the end of the name "Obamacare" which is odious to them and perhaps some other relatively minor changes. Democrats would insist on preservation of Medicaid funding and funding of pre-existing illnesses. Critics of this cud properly argue that just fixing Obamacare would have been simpler and Republicans could argue that much of Obamacare has been retained. What's in a name? Let's have an end to this.
3
Please. "Obamacare" was the GOP name for the Affordable Care Act initially! If you break it, you own it.
8
Your comment about the name Obamacare is funny. It was so named by the Republicans as part of their unending effort to demonize the ACA. For a time, they succeeded, but then Obama and the Democrats adopted the name and turned it around. They took away the negative aspects by accepting the name. Now you say Republicans hate that name? Could it be they hate because it is working relatively well. G.W. Bush said he hated the name "Bush tax cuts" for the wealthy but, having proposed and supported them, he's stuck with it.
If we don't have Obamacare, what do we get? Trump-don't-care?
If we don't have Obamacare, what do we get? Trump-don't-care?
4
I only used the term Obamacare as shorthand for the Affordable Care Act. I agree with you on how it came about. Unfortunately many Republicans won't support any changes that would help to improve it and Democrats won't vote to improve it if the name is changed. It seems the only sane man in the Senate is someone who just came through brain surgery and favors a bi-partisan approach to a an enormously important issue (health care). My comment was meant to suggest a way forward that alters and fixes some aspects of the ACA, preserves Medicaid funding, continues funding (adequate funding!) for those with pre-existing illnesses and hopefully doesn't get hung up what name attaches to it. The chaos in Washington is not exclusively the fault of either party. They both own it. Not mine, I couldn't bring myself to vote for either major candidate but I did cast my vote for Senator Schumer.. I don't regret that decision.
Eliminating the individual mandate isn't directly related to the budget and can't be passed under reconciliation. Dialing the penalty back to zero is a sham that, in effect, eliminates the individual mandate. The mere fact that a zero monetary penalty is related to the budget does not overcome a constitutional challenge to the use of budget reconciliation to circumvent the requirements of the legislative process outlined in the Constitution.
mB, SCOTUS practitioner
mB, SCOTUS practitioner
16
I read recently that people without any health insurance live longer that people that depend on Medicaid. Repeal it all and let the market sort it out.
I would trouble you with a nuanced discussion of why your observation about Medicaid is wrong, but I will tell you that there IS no health care insurance market and has been none for decades. We have a classic oligopoly, controlling prices and raising them every year.
22
A little familiarity with cause and effect, and the difference between causation and correlation would help make more sense of this - your comment is misleading.
People on medicaid are ALREADY sick, and in many cases disabled by illness. Medicaid didn't CAUSE that. They're on Medicaid because they are sick.
People without any health insurance are reasonably likely to not be ill. If they were ill, they'd apply for Medicaid if they didn't have/couldn't afford other coverage. People without health insurance may also tend to be young, and younger people overall tend to healthier (all things being equal.)
Also, where did you read it? The NY Times? Fox News? The New England Journal of Medicine? The fact that words can be read somewhere is obviously no proof of their veracity, as the election of 2016 taught us. It's fair to surmise, since you provide no details, that you've been hoodwinked by a source that provided the equivalent of "Fake News", confusing causation and correlation.
People on medicaid are ALREADY sick, and in many cases disabled by illness. Medicaid didn't CAUSE that. They're on Medicaid because they are sick.
People without any health insurance are reasonably likely to not be ill. If they were ill, they'd apply for Medicaid if they didn't have/couldn't afford other coverage. People without health insurance may also tend to be young, and younger people overall tend to healthier (all things being equal.)
Also, where did you read it? The NY Times? Fox News? The New England Journal of Medicine? The fact that words can be read somewhere is obviously no proof of their veracity, as the election of 2016 taught us. It's fair to surmise, since you provide no details, that you've been hoodwinked by a source that provided the equivalent of "Fake News", confusing causation and correlation.
36
Presumably because a significant proportion of those without any health insurance are the young and healthy who choose not to buy insurance?
8
I have respected John McCain for years, certainly without always agreeing with his positions. I was saddened and disappointed to hear of his vote in this health care travesty. I guess I had hoped he would consider the care he is currently receiving, and realize how fortunate he is to be able to get this care without worrying about how to pay for it, or bankrupting his family. Whatever they end up doing, the result is going to be more expensive premiums, higher deductibles, and fewer people able to afford or even have access to health care. We are on a headlong race to the bottom.
27
Medical insurance is not an a la carte menu--it works by pooling everyone's premium and paying for care for those who need it. It is not a matter of 'why should I pay for insurance that covers X because it is not relevant to me'; it is a matter of paying for comprehensive healthcare for everyone because it is not possible to predict what kind of care an individual might need. Ever heard of male breast cancer? It exists. Why should you pay for prenatal or maternity care if you are a man? Because providing prenatal and maternity care lowers the cost of having a child, which also lowers the cost of health insurance for everyone. When anyone ends up using the ER because either they do not have or can not afford medical insurance, that cost is redistributed to those of us who do have insurance. When rephrased using different terms, this argument is clearly flawed; how about, why should I be forced to pay for oncology care when I have decided not to have cancer? Life just does not work that way.
44
Well said
3
President Obama realized quickly that the ACA wouldn't work unless there was an individual mandate, like the one in those countries which have reached universal healthcare by mandated coverage. No country has universal coverage based on Republicans' "free market" theory. Any plan that wants universal coverage must have price regulations, whether it be mandated coverage or single payer. The government's regulation of prices is how the rest of the world pays far less than we do for healthcare. We need to do it, too.
21
I moved to New Zealand in 1979 for 10 years, then to Japan for 10 years, and since 1999 have lived and worked in Canada. Each of these countries (and most of Europe and the developed world) have national health care for all (plus affordable education through university). Yes, I paid somewhat more in taxes than I would have in the US, but I am still well off and have been happy that I - and everyone around me - have had this access to good health care. I have been relatively healthy, but this could and probably will change as I get older. Education and health care - fundamental rights, not rocket science.
66
If US insurance companies could duplicate the Canadian Plans, they wouldn't cover drugs or pay taxes. Lower your rates 30-35% tomorrow.
WR
WR
Who are these "independent analysts " and what actual data do they have that supports the statement that without the mandate insurance rates would go up?
Of course when less people are paying for coverage this will impact rates of the people paying insurance, but if there has been an increase in insurance coverage through the expansion of Medicaid, please explain how increasing coverage through Medicaid would not impact the rates of paying consumers?
Rather than use resources in expanding Medicaid, investment in expanding the workforce so more people can obtain full time work that provide healthcare insurance is a wiser means to address the issue for a longer term.
Of course when less people are paying for coverage this will impact rates of the people paying insurance, but if there has been an increase in insurance coverage through the expansion of Medicaid, please explain how increasing coverage through Medicaid would not impact the rates of paying consumers?
Rather than use resources in expanding Medicaid, investment in expanding the workforce so more people can obtain full time work that provide healthcare insurance is a wiser means to address the issue for a longer term.
No. Health insurance should have nothing to do with employment status. The risk and fear of losing employer-based coverage is a form of employee intimidation and that model needs to be blown up. What needs to happen is that for-profit health insurance companies should be phased out. Let the employees of those companies find something more productive to do. Most of the rest of us have been required to adjust to the changing economy and they should too.
22
Medicaid has no effect on the insurance pools on which individual health insurance companies base premiums. If young healthy people don't buy insurance, the pools for individual health insurance are older and less healthy. The young people will only buy coverage if they get sick or are injured if there is no penalty. Many people on Medicaid work full time, many are in skilled nursing facilities, and many are children. For working people, the employer mandate would require their employers to provide health insurance, instead of telling employees to apply for Medicaid so the rest of us subsidize their coverage. Some countries that have achieved universal coverage do so by way of individual and/or personal mandates. Of course, they also pay about have as much for healthcare because their governments recognize that healthcare is a right, and regulate prices of drugs, hospitals, tests, physicians, and health insurance.
5
Tying insurance to employment is one of the biggest problems with our system - for patients and insurers. By tying health insurance to employment - several disincentives emerge:
1) Tired of having to change doctors and/or medicines every year? Employers seek the lowest cost insurance they can get away with - which often means that employees will see their plans change frequently - creating instability in care and cost
2) Frustrated that you haven't had a raise in years? Employers use "higher benefit costs" as an excuse for not increasing wages. It's easier to cut benefits than it is to reduce wages.
3) "Gallbladder attack put you in the ER? Let's wait and see if you have another one before we spend the money for the surgery. By then you'll probably be with another employer or on another health plan - so it won't be our problem" Insurers have little to no incentive to give members any more care than absolutely necessary so they continue to pay premiums.
Our current healthcare financing system is an economic engine - it creates tons of jobs - someone has to push all that paper, adjudicate claims and fight denials. But couldn't our country do something better with scarce resources?
1) Tired of having to change doctors and/or medicines every year? Employers seek the lowest cost insurance they can get away with - which often means that employees will see their plans change frequently - creating instability in care and cost
2) Frustrated that you haven't had a raise in years? Employers use "higher benefit costs" as an excuse for not increasing wages. It's easier to cut benefits than it is to reduce wages.
3) "Gallbladder attack put you in the ER? Let's wait and see if you have another one before we spend the money for the surgery. By then you'll probably be with another employer or on another health plan - so it won't be our problem" Insurers have little to no incentive to give members any more care than absolutely necessary so they continue to pay premiums.
Our current healthcare financing system is an economic engine - it creates tons of jobs - someone has to push all that paper, adjudicate claims and fight denials. But couldn't our country do something better with scarce resources?
12
Why not consider an individual mandate for at least a catastrophic-level health insurance policy? Not as broad coverage as ACA-qualified policies but just what the conservative Heritage Foundation called for 25 years ago. Kind of a nice political compromise that might help to make lower- cost insurance for everyone a reality, no?
7
In addition to keeping the health insurance mandate to keep premiums reasonable for everyone, and putting a cap on recoverable medical malpractice damages, it's really not a terrible idea to get rid of some of the mandatory coverage items in Obamacare. For example, why should a woman who has decided not to have children be forced to have a policy that includes maternity care? This one item alone has caused my daughter to have not 1, but 2 successive Blue Cross policies cancelled as "insufficient coverage". Each replacement policy doubled her premium and her deductible went from $1,000 to $6,000. That's insane!! Insurers should be required to offer policies that cover maternity, but nobody should be required to buy that coverage just because they are female and of childbearing age.
As for how to lower the cost of doctor visits, this one is going to be really tough, and I hate to tell Mitch McConnell et al, but simply taking insurance away from the masses and having the citizens yell and scream at the doctors to lower their prices is not going to prompt the return of a $25 doctor visit. Some GOP pol was on NPR the other day spouting how it only cost him $25 a visit to see the doctor in 1970, so it should only cost that much now. If we all have to pay for routine visits out of pocket we can get prices lowered by complaining and doctor shopping.
The reality is that $25 of 1970 dollars is $160 worth of 2017 dollars. No amount of yelling is going to reduce that cost.
As for how to lower the cost of doctor visits, this one is going to be really tough, and I hate to tell Mitch McConnell et al, but simply taking insurance away from the masses and having the citizens yell and scream at the doctors to lower their prices is not going to prompt the return of a $25 doctor visit. Some GOP pol was on NPR the other day spouting how it only cost him $25 a visit to see the doctor in 1970, so it should only cost that much now. If we all have to pay for routine visits out of pocket we can get prices lowered by complaining and doctor shopping.
The reality is that $25 of 1970 dollars is $160 worth of 2017 dollars. No amount of yelling is going to reduce that cost.
6
Medical insurance is not an a la carte menu--it works by pooling everyone's premium and paying for care for those who need it. It is not a matter of 'why should I pay for insurance that covers X because it is not relevant to me'; it is a matter of paying for comprehensive healthcare for everyone because it is not possible to predict what kind of care an individual might need. Ever heard of male breast cancer? It exists. Why should you pay for prenatal or maternity care if you are a man? Because providing prenatal and maternity care lowers the cost of having a child, which also lowers the cost of health insurance for everyone. When anyone ends up using the ER because either they do not have or can not afford medical insurance, that cost is redistributed to those of us who do have insurance. When rephrased using different terms, this argument is clearly flawed; how about, why should I be forced to pay for oncology care when I have decided not to have cancer? Life just does not work that way.
10
Pregnancy is not a disease, it's a choice. It should not be covered.
And when you've got rid of planned parenthood
were is that choice?
were is that choice?
3
In every other developed country every citizen is required to participate in the healthcare system and pay in if they have an income. It’s no coincidence that all those countries achieve better results at much lower cost and with higher patient satisfaction.
People without coverage are a burden on others, get no preventive care and show up with advanced disease at ER’s and leave patched up with bills they can’t pay and the debt collectors after them, while the provider shifts the cost to others.
Any system that does not have universal coverage of minimum standard inevitably results in sick or at risk people buying in - and buying better policies - and the young and well opting out or buying bare bones plans making insurance more expensive for those that need it or those who wait until they do.
Any healthcare plan that will work covers everyone and has everyone contributing. This has been proven in country after country.
People without coverage are a burden on others, get no preventive care and show up with advanced disease at ER’s and leave patched up with bills they can’t pay and the debt collectors after them, while the provider shifts the cost to others.
Any system that does not have universal coverage of minimum standard inevitably results in sick or at risk people buying in - and buying better policies - and the young and well opting out or buying bare bones plans making insurance more expensive for those that need it or those who wait until they do.
Any healthcare plan that will work covers everyone and has everyone contributing. This has been proven in country after country.
31
This is basic insurance economics, which the Republicans pretend not to understand. Except our president, who doesn't need to pretend.
2
As part of my employment when I was younger , I can say for the first 5-7 years my use of my coverage was practically nonexistent. And not until I was in my middle 30s and after did I need it. Now that my husband and I are older and thank god he is a vet, but I haven't had coverage for over a year. I gladly will pay premiums, but not so an insurance company can pocket deductibles year after year, and still not cover most concerns. From the sound of this congress they still don't want middle class, poor coverage. This congress deserves all the animosity we the people have in our hearts, in our minds. We must remain tough as our fathers before us.
6
Collectively insurance is more expensive because people opt out until they feel they are at risk. This is not a criticism of you but if a system that allows people to risk their own health and financial well being by only paying into the system for part of their lives.
2
No offense taken. I do understand the whole insurance industry, what I object to is a $3-5000. Deductible. Then most average medical concerns never being covered. I'm retirement age now, didn't plan on over the years banking for just healthcare. And then not have it cover anything. Insurance companies are the new mafia protection game.
3
I had a medical procedure yesterday. In ambulatory surgery, a temporary device was placed in my back to try to eliminate excruciating long term pain. The device is my last resort. There is no Plan B for me. Because I had insurance the procedure cost me $1,100. The cost to the insurance company was just under $30,000. Had I not had insurance the cost would have been $58,000.
I am lucky and incredibly grateful. I have written about health care reform for almost 10 years. I helped champion Obamacare and knew it could be better. To have members of our Congress and the president promote any of the proposed health care bills is beyond the pale. I constantly try to understand why their collective disregard for the people in their respective states is so visceral and totally party-driven. I will give up trying to figure this out. I will now move forward with a vengeance to unseat as many Republicans as possible in the coming years. They have no understanding of what their constituents want or need. Nor do they care.
I am lucky and incredibly grateful. I have written about health care reform for almost 10 years. I helped champion Obamacare and knew it could be better. To have members of our Congress and the president promote any of the proposed health care bills is beyond the pale. I constantly try to understand why their collective disregard for the people in their respective states is so visceral and totally party-driven. I will give up trying to figure this out. I will now move forward with a vengeance to unseat as many Republicans as possible in the coming years. They have no understanding of what their constituents want or need. Nor do they care.
33
It is not that Republicans do not care for those who need their coverage supplemented, but it is not their desire to continually expand supplement coverage by expanding Medicaid as the only means to provide coverage for as many people as possible.
If Medicaid continues to be expanded to provide coverage for healthy younger citizens to obtain coverage, insurance rates for paying consumers will increase since the pool of paying customers is reduced.
If Medicaid continues to be expanded to provide coverage for healthy younger citizens to obtain coverage, insurance rates for paying consumers will increase since the pool of paying customers is reduced.
Is there empirical evidence of the republic party caring about individual citizens' health? they can say what they will- pray and and wave flags as well, but their actions speak loudly to those who are capable of putting two and two together.
2
There are several actions to take that would help lower the cost of health insurance for everyone, but nobody in the GOP seems to want to go there. First and foremost is mandatory coverage. Maybe we have the pitiful math education in the US school system to thank for all the citizens and politicians who don't understand why this works. The premiums paid by those who don't make claims on their policies helps to pay for the doctor/hospital bills of those who do. It's also what keeps the insurance companies from going bust because for each individual it's all the premiums you pay in good years that make you profitable even in the bad years.
Second, stop whining about mandates and accept responsibility for your contribution to health and wellness. Here we have mandatory automobile insurance. If you are in an accident and it's the other driver's fault, if you don't have insurance you pay a fine and you're not allowed to either sue the guilty driver or collect damages. You can choose to not own a car, but you can't choose to not have a body. Therefore if you get sick and don't have insurance you should pay a hefty price and accept responsibilitiy.
Third, put a cap on medical malpractice damages. I don't know the full effect of malpractice insurance on the prices charged to patients, but it's a large part of the overhead and it can be eliminated. This, however, requires cooperation from Democrats as they tend to favor plaintiffs and plaintiff's lawyers.
Second, stop whining about mandates and accept responsibility for your contribution to health and wellness. Here we have mandatory automobile insurance. If you are in an accident and it's the other driver's fault, if you don't have insurance you pay a fine and you're not allowed to either sue the guilty driver or collect damages. You can choose to not own a car, but you can't choose to not have a body. Therefore if you get sick and don't have insurance you should pay a hefty price and accept responsibilitiy.
Third, put a cap on medical malpractice damages. I don't know the full effect of malpractice insurance on the prices charged to patients, but it's a large part of the overhead and it can be eliminated. This, however, requires cooperation from Democrats as they tend to favor plaintiffs and plaintiff's lawyers.
14
You can't get something for nothing! That's what Trump basically promised. And his promises will never come true.
But you can, by cutting out insurance companies, arrive at universal Healthcare via Medicare for all. And Medicaid to cover copays and deductibles for the poor.
Throw in the VA system, the Military medical system, NIH, Public Health - which are already in place and paid for, and you have a really good integrated system.
We live in a wealthy country. We owe it to ourselves to - at least - have the universal coverage that other advanced nations already provide.
But you can, by cutting out insurance companies, arrive at universal Healthcare via Medicare for all. And Medicaid to cover copays and deductibles for the poor.
Throw in the VA system, the Military medical system, NIH, Public Health - which are already in place and paid for, and you have a really good integrated system.
We live in a wealthy country. We owe it to ourselves to - at least - have the universal coverage that other advanced nations already provide.
16
I do not fully understand why Democrats are so worried about the Republicans passing a repeal of healthcare. It is clear that this will have savage effects over a long time on many US citizens. On the other hand, it has been argued that repealing healthcare will make it clearer to low information voters what the importance of healthcare is. Some have claimed that repeal of Obamacare will insure that the midterm and 2020 elections will go strongly toward Democrats, in which case they can reverse the repeal. Is it felt that it is very difficult to get through congress any entitlement and that restoring Obamacare or going for single payer would be very difficult even if they sweep the midterm elections?
3
How does the employer provided healthcare market work? Certainly not by dividing sicker employees and putting them in a separate pool. No insurance plan can work unless most people don't need the insurance at any given time. It's not a burden to ask healthy Americans to participate in an insurance plan that they will certainly need as they get older. If it helps, consider healthcare insurance an intergenerational transfer tax like Social Security. Any other approach leaves older and sicker Americans to fend for themselves without the protective buffer of a broad insurance pool. Left in that condition, all but the wealthiest will lose everything to the inevitable costs of cancer, heart disease, knee replacements, etc. etc.. The lightly insured, younger, healthier Americans will receive a temporary tax benefit at the cost of facing the same struggles as they get older and sicker.
20
Obviously you understand insurance. None of the republicans seem to understand it at all. And it is the reason why we mandate car, business, and property insurance for everyone. It is why flood insurance is so expensive, because only those who live in the high risk areas would buy it.
But remember these are the people who wish to destroy SS and medicare and any help for the poor, so insurance being unaffordable for the poor is just icing on the cake for them.
But remember these are the people who wish to destroy SS and medicare and any help for the poor, so insurance being unaffordable for the poor is just icing on the cake for them.
11
The GOP certainly UNDERSTANDS it, they just don't care. The less fortunate just don't matter....
Exactly. What people seem not to realize is that when they have employer coverage, they are paying for sicker colleagues through the insurance premiums that would otherwise have been their wages.
Can the individual and employer mandates be repealed under reconciliation? They sound to me like policy requirements, not just budget items, so that 60 votes would be required. If so, surely they can't be passed. Could somebody clarify this?
1
The so-called skinny bill is a Trojan horse that will lead to a conference committee with the House to reconcile the two vastly different bills. Anyone who has been paying attention knows this means McConnell and Ryan will craft a very rightwing bill to satisfy the Freedom Caucus and the rightwing senators on the reliable assumption that the so-called moderates will fold, as they always do.
Then congress will face an up or down vote with no amendments. Can anyone really doubt how that will go after the bullying and the arm twisting are done ?
This is McConnell's last ditch effort to slash Medicaid and destroy Obamacare.
Be afraid. Be very afraid.
Then congress will face an up or down vote with no amendments. Can anyone really doubt how that will go after the bullying and the arm twisting are done ?
This is McConnell's last ditch effort to slash Medicaid and destroy Obamacare.
Be afraid. Be very afraid.
46
The only "priorities" the GOP has are to 1) undo as many of Obama's accomplishments as possible, and 2) cut taxes. They don't care about access to health care.
34
There is much about the US that puzzles non- Americans. Not least is the lack of care for the well-being of fellow Americans so evident among Republicans. The Australian health system has its flaws but the universal health cover provided by Medicare funded through personal income tax levies has overwhelming public support. So much so that at the last Federal election, the Coalition conservative parties came within one seat of losing office due in significant part to a perceived threat to Medicare. Why would you want to risk the health of the most vulnerable in your communities? All of the options to repeal and replace Obamacare will condemn millions to lives of preventable poor health and misery. It seems almost inevitable that Republicans in the Senate will pass such a bill. Unbelievable.
30
Here in the states, the right believes in everyone for themselves and if you can't make it, you don't deserve to be helped. It destroy the whole concept of a society and what the founders wanted, but that is what the conservatives are pushing for. No rules, no regulations, no laws, except for the ones that they want like bedroom laws which allows the government to dictate everything about sex and their so called morality.
1
It is called power and corruption. Republicans would sell their own mother down the river if it keeps them in power and makes money. Pish posh, worry about the health and lives of fellow Americans? How provincial. You and the world are watching the sinking of the American ship. No heart, no love for other people. Repeat after me-power and money. This is now the heart of American democracy. Sad.
1
The failure of the ACA to have a tough mandate is a huge part of the problem. Getting rid of the mandate and allowing people who are sick to sign up for insurance guarantees that sick people will buy insurance.
If you allow healthy people to opt out and sick people to buy why would any healthy person buy?
You can't have a Universal pool of insurance without everyone, healthy, sick, young and old being in the pool. That's the problem with the ACA. The Republican plan makes it worse.
If you allow healthy people to opt out and sick people to buy why would any healthy person buy?
You can't have a Universal pool of insurance without everyone, healthy, sick, young and old being in the pool. That's the problem with the ACA. The Republican plan makes it worse.
13
I have been saying that since the ACA went into effect, that the mandate is too weak. That is what is hurting the market, the young and healthy are not buying.
It is why we mandate other types of insurance like car, property, and business insurance. If we didn't, only those with high risks would buy insurance and thus the market would collapse.
It is why we mandate other types of insurance like car, property, and business insurance. If we didn't, only those with high risks would buy insurance and thus the market would collapse.
3
In other words, we need the money of the people who don't need insurance in order to pay for those who do. Yes, that is the principle of insurance, but the other types are voluntary in as much as you don't need to buy a car or property, etc. Here, you are basically being taxed for breathing. That's one approach, but people aren't stupid and the way the system is set up it allows for people to pick and choose. Perhaps if medical debt weren't able to be forgiven then people would have more of an incentive to insure. The mandate and penalty are ineffective and economically disproportionate to the risk.
1
"Reform" for Republicans seems always to mean, "let's spend less money on those left behind by economic changes beyond their control."
Reforming Obamacare should mean, "let's help the people whose health care became less affordable as a result of Obamacare while maintaining Obamacare for the over 20 million who had no health insurance at all without it."
I wish the Democrats were introducing a bill to do this real reform!
Reforming Obamacare should mean, "let's help the people whose health care became less affordable as a result of Obamacare while maintaining Obamacare for the over 20 million who had no health insurance at all without it."
I wish the Democrats were introducing a bill to do this real reform!
8
Democrats can introduce bills, but with 2 Senators/State there are not enough Democrats in the Senate (even though Democratic Senators represent the majority of people) to get a bill on the floor.
Now that debate has started, Democrats can and no doubt will introduce constructive amendments. Unfortunately, they will need votes from Republicans for their amendments to pass, and, in any case, heir amendments can only be to McConnell's bill...
What might have been : https://www.hillaryclinton.com/issues/health-care/
Now that debate has started, Democrats can and no doubt will introduce constructive amendments. Unfortunately, they will need votes from Republicans for their amendments to pass, and, in any case, heir amendments can only be to McConnell's bill...
What might have been : https://www.hillaryclinton.com/issues/health-care/
7
The Democratic Party could have come out swinging against this atrocity with a clear plan to move us towards single-payer. Instead, absolute silence — which is effectively deference, at this point. We need a better deal, but it doesn't seem to be coming from the likes of Schumer and company.
26
Come on. You are not being realistic. Single payer with this Congress? No way.
3
Yeah, let's blame the Democrats. Republicans tear down the house, so let's throw stones at the dems. With thinking like this, no wonder our country is going down the tubes.
The GOP had many years to work on improvements and all they could do is complain. And since it had Obama's name attached to it the ACA was a thorn in the GOP's side they couldn't stand. Ironically, ACA is a hybrid piece of legislation actually containing input from conservatives and conservative think-tank organizations. It wasn't perfect but recent evidence indicted it had more positive than negative.
The "skinny" is just ridiculous. It's a flaccid attempt by the GOP to get something into the laws so the GOP can say they created legislation to replace ACA even though it doesn't really do that. The GOP becomes more and more inane with time.
The "skinny" is just ridiculous. It's a flaccid attempt by the GOP to get something into the laws so the GOP can say they created legislation to replace ACA even though it doesn't really do that. The GOP becomes more and more inane with time.
14
You are correct in your first statement. As a Republican, it's incomprehensible that after 6 or 7 years, they did not have a plan ready to go. Beyond that, the ACA is a fatally-flawed piece of legislation that will die of it's own accord if the Republican's don't kill it first. Regrettably, the Republicans are hell-bent on the same force it down the throat approach that the Democrats used to pass the law in 2010. Just as that ended in political disaster for the Democrats, this too is likely to have a significant political cost.
1
So they voted to proceed without knowing what they're proceeding to vote for or against. Absurd.
19
This is shaping up to be the Iraq war of "healthcare." Make Republicans own any and all fallout from the skinny their skinny law, should it pass! Time for them to face the consequences of their actions.
12
A device tax of only 3% is too much? Give me a break! Device companies overcharge. Their profits are obscene. I was talking to a neurosurgeon who revealed that a battery he implanted in a brain cost $10,000. This is not far off from his own charge, this for just a battery compared to years upon years of training. That one of the 3 most important things to include in a skinny reform plan should be a measure to protect device company profits only showa what the priorities are for all the GOP and some of the Dems too. This not about affordable premiums, or increasing access, or doing anything to attack actual health care costs. This is about showing love to your lobbysist. This tax is nothing! What a corrupt bunch.
15
Did you ever stop and think how easy it is to research, develop, test, and finally bring to market a battery that might actually work in a human's brain. Or how an investor might think about the risk and reward associated with such an idea. Think about all of the things that could go wrong. Think about everything that needs to go right to make such a device work. Of course the materials don't cost $10000 but I would bet that all of the work involved in bringing such a device to market is very expensive, and if the size of the market is (hopefully) small, the device would need to be priced high to recover costs and generate profits for the company. The people who can intellectually create such devices and drugs have many choices in their lives and rightfully many will choose lucrative paths. We should encourage this so that these modern miracles continue to make the world a better place to live. It's very simple minded to look at prices and make rash decisions and opinions.
1
A surgeon placed a 1" pin in my foot during a planned surgery. No moving parts, no electronics, no battery, just a small, straight metal pin. The pin cost $1,800. Go figure.
5
Mike C: Innovation in device technology novel pharmaceutical technology should be rewarded of course. It's a matter of the magnitude of profit. (Just like CEO pay) And of relative values. What is the surgeon's skill worth relative to the device? The principle of a battery is simple compared to that. If the medication or device is priced so high that our healthcare system cannot provide them to even half of the patients who need them without going broke then the price is too high. Sadly what needs to be done but is not is head to head trials of the best products and meds so we as a society can support the truly best treatments. Companies avoid these like the plague so they can still push the illusion that their product is the "best".
Tech can produce big advances but the degree of profit that would still lure investment is overblown and lower than is currently the case. 3% tax is very reasonable especially since so many innovations are based on research initially taxpayer funded and not fairly compensated in proper amount of royalties.
Tech can produce big advances but the degree of profit that would still lure investment is overblown and lower than is currently the case. 3% tax is very reasonable especially since so many innovations are based on research initially taxpayer funded and not fairly compensated in proper amount of royalties.
The number of rural hospitals that will close didn't sway them. Got to help the rich at any cost.
14
The GOP is now an evil party led by an evil man.
This isn't about people. It's about money and power.
This isn't about people. It's about money and power.
19
Dear John McCain: The twentieth century called; it was your principles, saying they missed you and wanted you back.
16
McCain is a joke. He enjoys the healthcare public trough for over 30 years, recently enjoys the benefits of the best healthcare money can buy and then votes to proceed in the eventual ripping away healthcare for millions of Americans. Isn't he the true American hero? What a patriot!
Who is sick? U know who and they are in the Congress. We are the laughing stock of the world for our lack of compassion.
7
If the ACA is repealed or emasculated, I want my wife and everyone else to have the same government subsidised healthcare that Donald, Mitch and Paul R. have. Since they have it already, they know how good it is, so they should all realize that it will be good enough for the rest of us.
I do worry, however, that those royals might think that their plan is too good for us peasants. Do you think they might be so cold-hearted? After all, we're all Americans, aren't we? Or don't they think that we're good enough to have the same healthcare that they have?
I do worry, however, that those royals might think that their plan is too good for us peasants. Do you think they might be so cold-hearted? After all, we're all Americans, aren't we? Or don't they think that we're good enough to have the same healthcare that they have?
9
Or even let us buy into their plan at the average cost paid by the government per covered person. Let us buy into their large group insurance!
2
You know that can't happen; they get the special discount reserved for the decision makers...
"Skinny" repeal . . . what is this about? For the last 7+ years we heard from the Repubs is "repeal," i.e., gone, dead, history. That's what Trump's supporters were voting for, and now the Repubs want to make it "skinny?"
How dumb can the American electorate be?
How dumb can the American electorate be?
3
You see who is in the White House and ask that question?
2
This plan isn't going to happen... How can you give tax breaks to the rich without eliminating the 3.85% tax on other income......
3
Just look to the recent stories of people held hostage by Mexican hospitals until they pony up the cash to get out and you will see where our for-profit, free market health care industry is headed.
4
Way to lob a grenade into the individual market!
How can the insurance companies possibly set rates for next year with this bombshell tossed into the room, ready to explode?
Yay!
How can the insurance companies possibly set rates for next year with this bombshell tossed into the room, ready to explode?
Yay!
6
The GOP: legalizing Serial Killing. PEROID.
8
Skinny repeal, otherwise known as anorexic healthcare.
3
Fine. Pass the 'Skinny Repeal'. Strike it a win, throw a parade. Let President ManChild bask in a sorely soughtafter 'victory'.
Do all that absurd nonsense if it means we can FINALLY move on from this insanity. Maybe even consider doing something useful at last.
Do all that absurd nonsense if it means we can FINALLY move on from this insanity. Maybe even consider doing something useful at last.
2
GOP needs to pass something, anything for a legislative win to get this healthcare monkey off its back. It doesn't care WHAT is in the bill. I mean, truly, doesn't care.
3
China has national health care! Russia! We give Israel billions. They have national health care. But us, American workers are not worth it according to the GOP. We are parts that wear out and get replaced.
9
The USA spends about twice as much per person on health care as other developed countries. However, the prices paid by Americans or their insurance carriers for medical procedures are typically about triple what is paid in other developed countries. Hence, Americans consume less health care services than their foreign counterparts.
Government spending has been increasingly driven by medical care prices. Government pays half of the costs of health care in the USA. When the tax spending aspects of the tax deductibility and exclusions of medical care and insurance expenses are included, the impact of health care costs on the deficits is even larger. In many respects, the health care price crisis in uniquely American. Our Government spending on healthcare per capita exceeds that of any other country in the world, including those where there is very little private health care expenditures.
Adopting the second worst healthcare system in the world, Canada, Germany and the UK are probable the best candidates for that dubious honor, would allow the USA to eliminate much of the Federal budget deficit. That would help markets. See: http://seekingalpha.com/article/1522942 Being the second worst healthcare system after the USA, is like being the second worst nuclear accident in the last decade after Fukushima. There probably was another nuclear accident where a few people were injured in the last decade, but none comes to mind immediately..."
http://seekingalpha.com/article/1647632
Government spending has been increasingly driven by medical care prices. Government pays half of the costs of health care in the USA. When the tax spending aspects of the tax deductibility and exclusions of medical care and insurance expenses are included, the impact of health care costs on the deficits is even larger. In many respects, the health care price crisis in uniquely American. Our Government spending on healthcare per capita exceeds that of any other country in the world, including those where there is very little private health care expenditures.
Adopting the second worst healthcare system in the world, Canada, Germany and the UK are probable the best candidates for that dubious honor, would allow the USA to eliminate much of the Federal budget deficit. That would help markets. See: http://seekingalpha.com/article/1522942 Being the second worst healthcare system after the USA, is like being the second worst nuclear accident in the last decade after Fukushima. There probably was another nuclear accident where a few people were injured in the last decade, but none comes to mind immediately..."
http://seekingalpha.com/article/1647632
1
Obamacare repeal/replacement aside, let's not forget they plan to dismantle the 50 year old Medicaid plan that allows 60% of seniors in the US to afford nursing home care. What do we know with the elderly now, throw them in the streets?
10
Say after me- Republicans love money and power. Here is your answer.
3
We legalize and encourage assisted suicide. We tell people we are giving them the freedom to die with dignity. McCain should go first and show us how to do it. If he balks he should do the right and at least permit people to buy into the large group insurance that Congress representatives get.
1
GOP so worried about health bill votes. Wait til 2018 votes.
Insurance companies so worried about profits. Wait til no one can afford their policies.
Insurance companies so worried about profits. Wait til no one can afford their policies.
9
There needs to be an individual mandate that you have at least carry catastrophic care. You should not be forced to have a Cadillac policy but you should be forced to buy a very high deductible policy.
15
What is the point of "skinny repeal"? All it does is remove essential parts of the ACA (especially the individual mandate). It does nothing to increase coverage or lower costs.
Republicans hope skinny repeal could give them a "win," while doing somewhat less harm than the House and Senate bills.
Why don't Republicans work with Democrats to actually improve the ACA? Would it kill them to actually do something good for the country?
Republicans hope skinny repeal could give them a "win," while doing somewhat less harm than the House and Senate bills.
Why don't Republicans work with Democrats to actually improve the ACA? Would it kill them to actually do something good for the country?
82
The answer is Yes, it would kill them to do something good. Republicans don't care about doing good for the country. They care about being in power. There's not a patriotic bone in the crowd.
7
"Would it kill them to actually do something good for the country?"
I'm not sure if we really want to know the answer to that question.
I'm not sure if we really want to know the answer to that question.
5
I think Democrats are too generous with public health care dollars and Reublicans too stingy. If they worked together they might be able to find something that would allow everyone access to health care, but with more restrictions on what it would cover and what it wouldn't.
3
You cannot be too generous with public health care. You can indeed be too generous with tax breaks for the rich.
8
How would you feel about it if one of the things it didn't cover was essential to your health or even your life and you couldn't afford to pay for it out of your own pocket without going bankrupt?
2
Here is a thoughtful approach.
https://www.hillaryclinton.com/issues/health-care/
https://www.hillaryclinton.com/issues/health-care/
1
Burn down the village, to save the village. Vietnam.
Please Proceed, GOP. Karma, 2018. Bigly.
Please Proceed, GOP. Karma, 2018. Bigly.
41
You have to have a mandate just like on car insurance! Just watch live PD on Friday and Saturday nights from 9-12 the number one rated show! They said last night that over 50% of the police traffic stop involve people not having insurance, car registration and current driver licenses required by 49/50 of our states. Then these simple traffic stops lead to them finding people wanted on criminal warrants, felonies, drug smugglers, robberies, illegals, etc,
The problem was the mandate was not large enough. It needs to be at least 75% of the Bronze plan.
The problem was the mandate was not large enough. It needs to be at least 75% of the Bronze plan.
11
And yet a higher percentage of the Millennial generation have been opposed to the mandate and therefore helped the GOP's push to eliminate the mandate, which effectively will kill affordable healthcare for all. Not sure the millennials should be too proud about their 'me first'
philosophy!
philosophy!
6
Of course, there's no mandate to buy a car. But other than that...
2
Skinny repeal would be a big joke!
9
A big fat joke!
3
Honestly, I have no idea what the GOP stands for anymore, other than hating Obama and being scared of Trump voters. It's a pathetic state of affairs. Reagan would be disgusted.
87
Yup. Kill the private, free market part of the ACA, in the most chaotic way possible, to increase demand for Medicaid/Medicare buy-in/for-all. Sounds like a plan.
15
Single Payer, please.
54
"Let's take two wheels off the American healthcare car and see what happens to the 320 million passengers"
"Free-dumb !"
Great idea, Mitch McConnell.
"Free-dumb !"
Great idea, Mitch McConnell.
102
As everyone knows to but a house or use a car, there is a "mandate" to buy insurance. As our politicians, including Obama, never think of health care as a right, but nothing more different than homeowners and auto insurance, then still mandating health insurance should be done. But, done so, without paying a tax penalty.
Of course, when uninsured people try to access health care, they are given a prices list of what it will cost with insurance, and without. Of course, thsi requires either the state or the federal government to come up with a price list.
No one, up to now, has advocated setting prices for insured and uninsured, and make them consistent throughout various markets. If a person knew that cataract surgery wold cost $5000 an eye uninsured, but $1000 insured, what would think they would choose?
Of course, coming up with a price list, also reigns in health care costs. What a novel concept.
Out of the mess the GOP proposed, the "skinny repeal" does have some merit. And, guess what? Maybe from there both parties can fix the other broken part of the ACA. What a bigger novel concept.
Finally, the real goal here is get everyone access to health care, without them going bankrupt The ACA was a first step. Getting rid of the provisions, discussed here, will make it better. Throwing in what a patient would pay insured and uninsured is far better to get coverage than hitting people with income tax penalties. And, this may make it easier to get to single payer.
Of course, when uninsured people try to access health care, they are given a prices list of what it will cost with insurance, and without. Of course, thsi requires either the state or the federal government to come up with a price list.
No one, up to now, has advocated setting prices for insured and uninsured, and make them consistent throughout various markets. If a person knew that cataract surgery wold cost $5000 an eye uninsured, but $1000 insured, what would think they would choose?
Of course, coming up with a price list, also reigns in health care costs. What a novel concept.
Out of the mess the GOP proposed, the "skinny repeal" does have some merit. And, guess what? Maybe from there both parties can fix the other broken part of the ACA. What a bigger novel concept.
Finally, the real goal here is get everyone access to health care, without them going bankrupt The ACA was a first step. Getting rid of the provisions, discussed here, will make it better. Throwing in what a patient would pay insured and uninsured is far better to get coverage than hitting people with income tax penalties. And, this may make it easier to get to single payer.
5
A price list on the surface sounds good but every provider is going to charge different rates. Also, a price list does not help when you are in an emergency, who has time to shop around while you are having a heart attack.
6
DerekGator,
Ask a Canadian, they know upfront what a procedure will cost. Even though they do not have to pay for it out of pocket. Pricing can easily be found on any province health care site.
Ask a Canadian, they know upfront what a procedure will cost. Even though they do not have to pay for it out of pocket. Pricing can easily be found on any province health care site.
4
Actually the mandate to buy house insurance does not come from the government but from the banks to protect the mortgage. If you buy with cash, you don't "have to" have house insurance but it would be unwise not to protect your investment.
The arguments against mandated purchase of insurance are without rational reason and labeling this mandatory purchase 'unconstitutional' or 'state over reach' is without logic. Every State in the USA requires - MANDATES- drivers purchase a minimum level of vehicle liability insurance, the minimum standards are dictated by each State. If auto insurance were not mandated and minimum standards established, the cost of insurance would be prohibitive.
54
The difference being, of course, that there is no mandate to buy a car. Hence, one can opt out of the system entirely.
3
All but NH requires car insurance. We here in the Live Free or Die state still have optional car insurance coverage, but big penalties if you get in an accident as an uninsured motorist and it's your fault. That's thanks to the GOP in my state - ugh.
1
One can't opt out of the health market. Sooner or later, you will need it.
1
Anything for a win so Trump can gloat. Most of his supporters will never know the difference.
55
Trump may not be smart enough to see it, but the 3 Republican Senators who defeated this latest attempt actually probably saved Trump from his Pyrrhic "win" which might have point points on the legislative board but ultimately in the long run would have probably wrecked his Presidency and the GOP majorities if anywhere close to the CBO predictions became true of the consequences of the GOP legislation. He had literally no clue what he was prepared to sign into law and how it would have probably made health care worse for many of his own supporters, not to mention Americans at large. He has surrounded himself with right wing ideologues like Tom Price and Mick Mulvaney who are directing him away from his "unorthodox" Republicanism he hinted at on the campaign trail and placing him instead firmly in the path of implementing long term unpopular and destructive policies that are the exact opposite of "draining the swamp". God knows what Trump supporters are actually envisioning will come out of this mess but the populist economic revival it ain't.
I really don't care about "paperwork" for businesses. If you can't afford to pay decent wages and provide healthcare for people who work for you, go out of business. Business 101, make sure you can afford overhead.
The employer mandate, was one of the most valuable aspects of the ACA.
The employer mandate, was one of the most valuable aspects of the ACA.
55
Sounds simple but American businesses have to compete with foreign businesses and American businesses operated with illegal employees.
1
That's the attitude. Let's add more burdensome regulation and paperwork on employers - large and small. Have you ever attempted to complete some of these forms? Or understand the fees and costs associated with such mandates? Do you wonder why uber and the rest of the temp and gig economy is thriving? Much of it has to do with avoiding the "overhead" imposed on businesses for truly non-value-added activities. These are then passed on to the consumer - or perhaps, it's simpler to move the jobs to Mexico or India.
3
I heartily agree. Who writes a business plan to hire part time workers, pay a sub living wage, and provide no benefits? And then consider them self a job creator? That is not something to be proud of.
1
Dean Heller has to go. He represents Steve Wynn and Sheldon Adelson, not the people of Nevada. This is not a government of the people, by the people and for the people!
67
He's basically already gone,. One less Republican senator in 2018.
1
Oh, well, all they have to do is say that it does not in fact clash, and that'll be that. Easy!
2
What a great nation we could be if only we would all work together, if Congress could work together, for the good of the American people, not for political victories. Our nation stands above all others, we are powerful but not hungry to invade others, we are rich and are always sharing our wealth with the unfortunates, other nations would offer anything if they could have our freedoms and opportunities. Please, Congress, show a heart and understanding, and do the right thing with this project of Insurance for all. God bless America and preserve it always.
4
Not hungry to invade others? Check out long history with Latin America back to the Monroe Doctrine which was to warn Europe off, not keep us out. What do you think "banana republics" means? Invaded Iraq. Invades Cuba on pretext that "they" blew up the Maine when it turns out it was an internal explosion. Invaded Mexico and Lincoln, in Congress as a one-term Representative, was anti-war and challenged someone to show him the spot of blood where American blood was shed there. Invaded Vietnam with the bogus story of ships being fired on in Tonkin Gulf. Suggest you study some American history. But at least we both are against Trumpcare which is FreeDumb.
Republicans are not trying to do anything constructive.
They just need something they can put in an ad.
At election time, they will berate Democrats who vote to continue the mandate, while hoping to hold onto their own seats by bragging that they voted to remove the mandate, assuming that voters can be fooled by their ads and ignore the fact that "...eliminating the individual mandate would ...[raise] prices and [reduce] enrollment."
Watch out as Republicans in their ads will blame the increased prices and decreased enrollment that their votes cause on the so-called "failures" of Obamacare.
They just need something they can put in an ad.
At election time, they will berate Democrats who vote to continue the mandate, while hoping to hold onto their own seats by bragging that they voted to remove the mandate, assuming that voters can be fooled by their ads and ignore the fact that "...eliminating the individual mandate would ...[raise] prices and [reduce] enrollment."
Watch out as Republicans in their ads will blame the increased prices and decreased enrollment that their votes cause on the so-called "failures" of Obamacare.
56
This is at best an extremely confusing piece of journalism. At worst, it's downright disingenuous. Is the death spiral that would ensue after repealing the individual and employer mandates under the ACA supposed to be an upside?
Does the fact that some Democrats support taxing the medical device industry even matter? No democrats are voting for the ACA repeal.
Is the author actually suggesting that the 30 million Americans who will lose health insurance should somehow be relieved by the fact that Barack Obama once campaigned on a version of the ACA without mandates nearly 10 years ago?
But wait, there's still a downside to this thing.
Does the fact that some Democrats support taxing the medical device industry even matter? No democrats are voting for the ACA repeal.
Is the author actually suggesting that the 30 million Americans who will lose health insurance should somehow be relieved by the fact that Barack Obama once campaigned on a version of the ACA without mandates nearly 10 years ago?
But wait, there's still a downside to this thing.
22
It was written rapidly.
RE: "The individual mandate is unloved because no one likes being told what to do."
If the Republicans don't want the mandate which required people to buy insurance or face a penalty, thus expanding the pool for coverage, than they must also eliminate the requirement for hospitals to render care whether the person can afford it or not. That is the only way to A) be consistent with their purported conservative principles, and B) provide incentive to people to buy insurance without requiring it. If you get sick or injured you must have cash or insurance or you have no treatment. Just like if you crash your car and want it fixed.
Otherwise mandated coverage is a conservative principle of as it requires people (that vast majority of which cannot afford to self-insure) to have coverage for the health care and not be a burden - or at least less of a burden on others if their premiums are subsidized.
That or fix the ACA from Republican sabotage or go to single payer.
If the Republicans don't want the mandate which required people to buy insurance or face a penalty, thus expanding the pool for coverage, than they must also eliminate the requirement for hospitals to render care whether the person can afford it or not. That is the only way to A) be consistent with their purported conservative principles, and B) provide incentive to people to buy insurance without requiring it. If you get sick or injured you must have cash or insurance or you have no treatment. Just like if you crash your car and want it fixed.
Otherwise mandated coverage is a conservative principle of as it requires people (that vast majority of which cannot afford to self-insure) to have coverage for the health care and not be a burden - or at least less of a burden on others if their premiums are subsidized.
That or fix the ACA from Republican sabotage or go to single payer.
81
I think we'd have to go farther than that to get through to thick-headed believers in the healthcare "free market." I suggest that those who choose not to have insurance and cannot pay cash for treatment not only be turned away from hospitals, they should have that refusal tattooed across their foreheads. And then, when they're lying in the road after a massive car accident, we just leave them there. Let them take personal responsibility and pull themselves up by their bootstraps. That's their prescription for everyone else, after all.
And oh yeah, any medical professional or Good Samaritan who treats a person with that tattoo faces a mandatory prison sentence.
Harsh? Absolutely. But honestly, I'm no longer sure that anything will get through to people who are already so intellectually blind that they can't look around at the rest of the world and see that, when it comes to providing healthcare to our citizens, we are a third world nation. This should not be necessary in a civilized nation: https://www.nytimes.com/2017/07/23/us/healthcare-uninsured-rural-poor-af...
And oh yeah, any medical professional or Good Samaritan who treats a person with that tattoo faces a mandatory prison sentence.
Harsh? Absolutely. But honestly, I'm no longer sure that anything will get through to people who are already so intellectually blind that they can't look around at the rest of the world and see that, when it comes to providing healthcare to our citizens, we are a third world nation. This should not be necessary in a civilized nation: https://www.nytimes.com/2017/07/23/us/healthcare-uninsured-rural-poor-af...
6
I don't like being mandated to have car insurance, but I'm sure glad I do.
If you weren't required to have government-issued license to drive a car, you wouldn't be mandated to have car insurance. You're not required to drive a car. That's the difference with health insurance. You don't need a government-issued license to be alive, yet everyone is mandated to have health insurance, nevertheless. The answer is a tax-funded single payer system.
Republicans are more interested in simply getting some kind of "repeal win" on the record vs. improving health care for Americans. Sad.
122
The simple answer to health care is Medicare for everyone.
147
Simple and unworkable. Medicare has no maximum out of pocket limits, costs roughly $10,000 per person, and reimburses docs and hospitals at a rate 40% higher than Medicaid. It also has annual and lifetime limits on treatment, like hospital days and does not include prescription drug coverage.
This new "medicare for all" option would REQUIRE private insurance overlays to offer any real protection. Just like now.
Is that really what you are after?
WR
This new "medicare for all" option would REQUIRE private insurance overlays to offer any real protection. Just like now.
Is that really what you are after?
WR
The "skinny bill" looks like a tool to destroy what will remain of the ACA. The ACA was based on people being required to have insurance. If there is no mandate for coverage, it will be nearly impossible for insurers to offer policies that most people can afford.
113
As described, it may only kill the private sector, free market part of the ACA. The Medicaid expansion may now be untouchable.
1
Yes and that is already a problem because the penalties are not big enough - and people don't understand the "you will be charged 3 times as much at the hospital" penalty of not having insurance. However, if the GOP pass the skinny bill, they will have taken ownership of the future rate increases.
4