Oh, please, what a narrative. We're never going to get anywhere with such stark misrepresentations. Expanding Medicaid is not a sustainable healthcare plan unless one is planning endless subsidies financed by permanent redistribution. Such a program disincentivizes production meaning a shortfall of supply. It's slogan should be "Welcome to free health care you will never get!"
Expanding Medicare is entirely doable.
If the whole country pitches in and supports laws that limit profiteering on this basic human need, we'll be fine. Actuarial work that is currently handled by people working in the insurance business can be done well without the expense of a massive layer of corporate bureaucracy. Ditto for Hospital management expenses. Ditto for pharmaceutical lab commercial profits. Ditto for doctors and medical schools who price-gauge.
Good money for good work providing medical care.
And no money for fly-by-night people interested in making a killing by doing mediocre tasks that are completely peripheral to medicine.
If the whole country pitches in and supports laws that limit profiteering on this basic human need, we'll be fine. Actuarial work that is currently handled by people working in the insurance business can be done well without the expense of a massive layer of corporate bureaucracy. Ditto for Hospital management expenses. Ditto for pharmaceutical lab commercial profits. Ditto for doctors and medical schools who price-gauge.
Good money for good work providing medical care.
And no money for fly-by-night people interested in making a killing by doing mediocre tasks that are completely peripheral to medicine.
7
How did the headline writer come up with "Softly"? This is killing the program incrementally and there is nothing soft about it.
But soft or hard, the core Republican voters will be supporting their GOP leaders even as many of those voters lose their health care. This country's urge to self-destruct, while worrying about external enemies, is inexpicable.
But soft or hard, the core Republican voters will be supporting their GOP leaders even as many of those voters lose their health care. This country's urge to self-destruct, while worrying about external enemies, is inexpicable.
4
It seems that the goal is not to pass legislation in order to help Americans but simply to undo (at any cost) what President Obama did because they said they would.
6
Why democrats in congress have not been able to articulate these points when they have been so obvious over the years is beyond treason!
3
This admin is a disgrace, they should all be in prison. Using ACA money to fund ads against it is a felony and breaks federal law yet the enablers in Congress do nothing. You have not seen anything yet, the House is currently working on a 10 year plan to whach 5.4T out of entitlements including 500B to Medicare, I have had enough of these goons and criminals, have you......
4
And now the shell game! (Oh, we couldn't possibly support this, unless of course the House agrees to conference, so it is really still just procedural, so we aren't on the hook, are we?).
The Republican strategy was never in doubt. The GOP will do anything and everything to disrupt and destroy the ACA and then say that they predicted its demise. Their sabotaging of this program has been in the works since McConnell boldly stated his intention to to go against anything President Obama tried to put into place. That was nearly eight years ago. He is now working hard to reach his goal and the goal of his party. A very sick leader of a very sick political party.
8
Killing Obamacare softly? I disagree.
It's more like throttling a patient who refuses to die.
For all the years that Republicans have been in lockstep about taking down the Affordable Care Act, one might have thought they'd come up with something better than outrightly killing off 22+ MILLION Americans, while reaping the rewards for themselves and their wealthy contributors.
That said. At least some members of the narcoleptic Congress have recently shown signs of gumption by not going along for the ride -- that still doesn't excuse those who keep pounding out this garbage to begin with.
But the worst thing about this all is that it has absolutely nothing to do with providing healthcare; instead it's nothing more than a Ponzi scheme built on the backs of those who can least afford it, and for one reason only -- to settle the personal vendetta this president has against his predecessor.
This isn't making America great again.
And no matter how you look at it, this isn't winning.
It's more like throttling a patient who refuses to die.
For all the years that Republicans have been in lockstep about taking down the Affordable Care Act, one might have thought they'd come up with something better than outrightly killing off 22+ MILLION Americans, while reaping the rewards for themselves and their wealthy contributors.
That said. At least some members of the narcoleptic Congress have recently shown signs of gumption by not going along for the ride -- that still doesn't excuse those who keep pounding out this garbage to begin with.
But the worst thing about this all is that it has absolutely nothing to do with providing healthcare; instead it's nothing more than a Ponzi scheme built on the backs of those who can least afford it, and for one reason only -- to settle the personal vendetta this president has against his predecessor.
This isn't making America great again.
And no matter how you look at it, this isn't winning.
6
Despite a concerted effort on the pat of the Republicans & their champion Tom Price, a physician with a "damaged heart," Obamacare seems to be limping along. The fact that 7 Republicans were brave enough to vote against our (diabolical) president shows Obamacare, though wounded, is likely to survive.
If the Democrats try hard, one or both Houses would flip next year. And that would give a new life to Obamacare. If not, still Obamacare can & will survive. It has to. We all have to make a concerted effort to educate the public the real story behind this Republican sabotage. Devise some catch phrases to use in the next election. Expose the hard hearted Republicans, Ryan, Price, Mulvaney & Trump!
If the Democrats try hard, one or both Houses would flip next year. And that would give a new life to Obamacare. If not, still Obamacare can & will survive. It has to. We all have to make a concerted effort to educate the public the real story behind this Republican sabotage. Devise some catch phrases to use in the next election. Expose the hard hearted Republicans, Ryan, Price, Mulvaney & Trump!
4
Softly? This Senate is ruthless, creating continued stress around life or death issues for people and their kids. Everybody needs healthcare.
5
Why is it that no democrats are appearing on the many talk shows and making this point?
2
The regressives are taking the ACA exactly where they want it. Straight to the dump. The regressives prefer to allocate the sick poor and elderly to doom rather than having to lower themselves to dealing with progressives. Swamp rules state that if you can't accomplish it on the up and up then sleaze, deception and lies are perfectly acceptable. Same day, different pitch, the rich win everyone else suffers or dies, whats new.
3
Govt., via ACA, mandated individuals to buy a product from "private" entities.
On top of that, govt. mandated what must be included in that product (essential benefits).
On top of that govt. provided subsidies to individuals to buy that product.
(Although govt. subsidy also exists in employer sponsored market in the form of tax deduction)
This is a matter of economic principle, whether you support crony capitalism or oppose it.
On top of that, govt. mandated what must be included in that product (essential benefits).
On top of that govt. provided subsidies to individuals to buy that product.
(Although govt. subsidy also exists in employer sponsored market in the form of tax deduction)
This is a matter of economic principle, whether you support crony capitalism or oppose it.
2
Since the implementation of the ACA, my rates are higher, my deductible is higher and my OOP is higher, what's not to like? In essence more and more people have a insurance card that they can't afford to use. Blaming the GOP is suggesting the Dems have it figured out and simply won't share their "cure". Staring over to address the 92% who didn't receive anything from the ACA might be politically wise.
3
MEM6, President Obama and the Democrats never said that the ACA was perfect and would never need some fixes. Most of the data show that the system is working well to cover people who were not able to afford health insurance before ACA. In addition, health care insurance was going up before ACA and the pre-ACA system was bankrupting federal and state governments, businesses, and individuals. Only a fool would want return to it. High deductibles and out of pocket expenses are built into the Republican "fixes." Finally, the Democrats do have some suggestions for fixing ACA. When was the last time Republicans wanted to listen?
4
Why the government's killing its own health insurance program by degrees isn't bigger news is a mystery. The healthcare legislation in Congress is covered like a football game--who's ahead. But who's really losing are all the people who have been helped by the ACA. This succinct summary of what Trump has done to undermine the ACA should be a regular headline, not buried in an editorial.
8
I hope I never see the squatter in the white house. I may lose my self control.
How can these antics be legal?
How can these antics be legal?
8
If the middle class is not dependent for security on the government (or, in the case of health insurance, on employers), it will have to buy security, which will generate business opportunities for entrepreneurs. Since security has the property that it is paid for now and delivered later, it creates many openings for scams in which what is promised turns out to be unavailable when it is needed. People who are at home with complexity and marketing and making things seem better than they are will have ample opportunity to relieve those who are not at home with these things of their money. People who are not or cannot be or do not want to be conversant with how to tell a real good deal from a fake one, prefer to leave important aspects of their security to government.
The middle class includes both those whose jobs involve making things seem better than they are and those who are vulnerable to these seemings. The former have an interest in keeping government as small as possible, while the latter want a government big enough to provide the security they do not want to constantly worry about. The former want to run things that involve gambling, particularly if they can be the house or rig the game, while many of the latter do not enjoy gambling, and especially not when the stakes are their future.
The middle class includes both those whose jobs involve making things seem better than they are and those who are vulnerable to these seemings. The former have an interest in keeping government as small as possible, while the latter want a government big enough to provide the security they do not want to constantly worry about. The former want to run things that involve gambling, particularly if they can be the house or rig the game, while many of the latter do not enjoy gambling, and especially not when the stakes are their future.
6
Thank you for a fantastic review, and for making explicit what bystanders who support Obamacare did not bother get informed about. You make explicit, the clever, systematic, sustained, step-by-step defoliation that is occurring. No one should mistake the conservative attacks, and Kristol's faux gravel-on-gravel voice, or views, as anything other than an advocacy for "if you are poor, you should die slowly and painfully, hopefully alone while hating the people we want you to hate. If you are middle class, you should live in fear."
The driving motivation of all conservatives: do everything to keep people either ignorant and fearful, or plain fearful and anxious. The swollen amygdalas, high anxiety crowd votes republication.
It explains why conservatives talk of liberty (when they are for a theocracy), fiscal conservatism (when they are the first to feed completely on the government teat, and spend us into penury), and personal responsibility (when they favor dependency fostered by ignorance, hatred, spite, fear, and loathing).
But then I saw Schumer (whom I personally like as my senator) and his friends speak in the hot sun, fading with heat and thirst, muling and puking: "Trump voters, come to us, we will do great for you."
"Ineffectual" would be too kind a description, pathetic and sad not nearly there.
Your article calls for something new: the unleashing of anger from the center; and a call to organization and action.
Kalidan
The driving motivation of all conservatives: do everything to keep people either ignorant and fearful, or plain fearful and anxious. The swollen amygdalas, high anxiety crowd votes republication.
It explains why conservatives talk of liberty (when they are for a theocracy), fiscal conservatism (when they are the first to feed completely on the government teat, and spend us into penury), and personal responsibility (when they favor dependency fostered by ignorance, hatred, spite, fear, and loathing).
But then I saw Schumer (whom I personally like as my senator) and his friends speak in the hot sun, fading with heat and thirst, muling and puking: "Trump voters, come to us, we will do great for you."
"Ineffectual" would be too kind a description, pathetic and sad not nearly there.
Your article calls for something new: the unleashing of anger from the center; and a call to organization and action.
Kalidan
5
GOP definitely OWNS healthcare. Most Americans realize that the Democrats have been locked out of the process. The GOP says a lot of things and their actions show the truth; all they care about is fulfilling a campaign promise, not taking care of the US. We see you, GOP!
13
Perhaps an actual WORKING health plan is in order? But then, again, you write for the Times.
2
This op ed is too important to have a narrow readership, especially now when the republican congress has a full assault on the ACA.
Front and center above the fold highlight the many ways that are being used to undermine and finally break up the marketplace of the ACA.
Just bold print bullet points, keep it simple, and it may get read.
Front and center above the fold highlight the many ways that are being used to undermine and finally break up the marketplace of the ACA.
Just bold print bullet points, keep it simple, and it may get read.
5
Price should be fired. Also Pruitt, of course.
3
The "death of a thousand cuts" attempt by Republicans to kill Obamacare shows how disconnected politicians have become from the people who voted them into office. They have no concern for their welfare, and indeed behave like foreign conquerors who want to subjugate and punish Americans for the sin of merely being alive.
The motto of the Trump administration shouldn't be "Freedom" or "Make America Great Again," but "Vae victis, an ancient Latin phrase meaning "woe to the vanquished."
The motto of the Trump administration shouldn't be "Freedom" or "Make America Great Again," but "Vae victis, an ancient Latin phrase meaning "woe to the vanquished."
5
The changes to Obamacare being pushed by Republicans:
"would raise premiums, out-of-pocket costs, or both"
It's frustrating to read this as being some sort of theoretical possibility in the future when the introduction of Obamacare itself, had this exact effect on many of us. Since it's implementation we pay (through our employer sponsored plan) higher premiums, higher deductibles, and get lower percentages of the treatment costs covered. This is not insignificant and affects more people since the majority get coverage through their employer. The news media, the NYT included, simply chooses to ignore this inconvenient truth.
"would raise premiums, out-of-pocket costs, or both"
It's frustrating to read this as being some sort of theoretical possibility in the future when the introduction of Obamacare itself, had this exact effect on many of us. Since it's implementation we pay (through our employer sponsored plan) higher premiums, higher deductibles, and get lower percentages of the treatment costs covered. This is not insignificant and affects more people since the majority get coverage through their employer. The news media, the NYT included, simply chooses to ignore this inconvenient truth.
1
A dissenting voice here. There are too many people, especially too many old retired people. The republicans have a solution, lower the average life expectancy. Kill off some of the excess population. Who better to kill off than the lower end of the economic scale. Obviously the people nominated for earlier death are in complete agreement since they are the people electing the rpublicans. Democracy in action!
6
To the assertion that Price engaged “... in efforts to discredit the ACA”, to paraphrase The Producers, “It didn’t need our help”.
After 8 years of utter lawlessness, (as when BHO illegally postponed tax increases for political purposes) Congress is to be excused from acting to prevent the POTUS from simply flouting the law; Judge Collyer is to be congratulated for upholding the law.
The GOP doesn’t need to engage in “subterfuge”, nor make the slightest attempt to undermine the ACA; it will do that all by itself.
When the left employs the word “affordable”, that translates into English as “taxpayer funded”. Precisely nothing in the ACA was designed to cut costs (save, perhaps, the $700B cut to Medicare, a program the Dems claim to be willing to defend to their last breath). We COULD do that, by insisting on price transparency from providers, eliminating coverage mandates, permitting interstate competition among carriers, encouraging HSAs. In short, something akin to what the Swiss do, sans the nasty “individual mandate”. (They individually pay for much of their health care and insurance out of pocket, which encourages prudent use of resources.)
Free lunches may be hugely popular with the diners, but, eventually, someone has to pay for them. No one who defends the ACA without some proposal as to how to actually pay for all the freebies, handouts, and giveaways, simply cannot be taken seriously.
After 8 years of utter lawlessness, (as when BHO illegally postponed tax increases for political purposes) Congress is to be excused from acting to prevent the POTUS from simply flouting the law; Judge Collyer is to be congratulated for upholding the law.
The GOP doesn’t need to engage in “subterfuge”, nor make the slightest attempt to undermine the ACA; it will do that all by itself.
When the left employs the word “affordable”, that translates into English as “taxpayer funded”. Precisely nothing in the ACA was designed to cut costs (save, perhaps, the $700B cut to Medicare, a program the Dems claim to be willing to defend to their last breath). We COULD do that, by insisting on price transparency from providers, eliminating coverage mandates, permitting interstate competition among carriers, encouraging HSAs. In short, something akin to what the Swiss do, sans the nasty “individual mandate”. (They individually pay for much of their health care and insurance out of pocket, which encourages prudent use of resources.)
Free lunches may be hugely popular with the diners, but, eventually, someone has to pay for them. No one who defends the ACA without some proposal as to how to actually pay for all the freebies, handouts, and giveaways, simply cannot be taken seriously.
1
Every other industrialized country can sustain a better health care system than the US. At lower cost.
Now what?
Now what?
6
It's so sad to see cruel, cynical Republicans get away with imposing unnecessary sickness and death on such a huge swath of Americans. And so many of those who'll be devastated will be so uninformed and confused by all of the bad-faith rhetoric coming from the GOP and their enablers in the press that they won't realize what hit them until it's too late. We can't have nice things for regular people in this country--the Republicans wouldn't stand for it.
1
The question almost never asked by the NY Times is: Why doesn't somebody (Democrat or Republican) suggest universal health care for Americans?
One of the most severe problems with the Affordable Care Act is its complexity.
Economists have a hard time explaining how the mandates actually cut down costs. And many of America's poor don't understand the complex arguments. This is not because of stupidity, but because complexity makes it impossible for ordinary people to understand the ACA.
Should I spend hard-earned dollars on mandates which give me coverage filled with deductibles and charges I cannot afford?
For the poor, no good decisions are possible. It is foolish to think that they can be savvy consumers in a complex marketplace filled with numerous alternatives.
In fact, even those of us who have good-paying jobs find it difficult to make decisions about which of several options of health care to take. Should I give up my job so that I can study the fine print in the reams of material the insurance companies expect me to read?
What the poor people need, as well as those with middle income jobs, is a simple health care system, like universal health care.
The ACA is an invitation to subterfuge by politicians.
Keep it simple. Above all, universal health care would FORCE Americans to consider the costs of continued growth.
It would then be blindingly obvious that
THERE ARE LIMITS TO GROWTH.
And WE MUST STOP ILLEGAL IMMIGRATION.
One of the most severe problems with the Affordable Care Act is its complexity.
Economists have a hard time explaining how the mandates actually cut down costs. And many of America's poor don't understand the complex arguments. This is not because of stupidity, but because complexity makes it impossible for ordinary people to understand the ACA.
Should I spend hard-earned dollars on mandates which give me coverage filled with deductibles and charges I cannot afford?
For the poor, no good decisions are possible. It is foolish to think that they can be savvy consumers in a complex marketplace filled with numerous alternatives.
In fact, even those of us who have good-paying jobs find it difficult to make decisions about which of several options of health care to take. Should I give up my job so that I can study the fine print in the reams of material the insurance companies expect me to read?
What the poor people need, as well as those with middle income jobs, is a simple health care system, like universal health care.
The ACA is an invitation to subterfuge by politicians.
Keep it simple. Above all, universal health care would FORCE Americans to consider the costs of continued growth.
It would then be blindingly obvious that
THERE ARE LIMITS TO GROWTH.
And WE MUST STOP ILLEGAL IMMIGRATION.
1
The small-minded leaders of the assault will only back off when it's clear to them that Rs in general, and Trump in particular, are absorbing the blame for degradation of the market and regulatory forces that are supporting the ACA. Responsible state officials must pursue the right path of litigation to stop it and the Ds have to ramp up a vicious PR assault to show the administration that they too can bring guns to a knife fight.
1
As every day passes, since January 20th, when our latest corporate ruler was sworn in, to protect and serve corporate America, "we the eternally stupid American people", have begun to wake up to the realization that fully half of the nation elected this corporate shill, and his corporate cronies, as the rulers of all of us, intent on completing the disenfranchisement of the masses, begun some 50 years ago.
Of course we now know the election was a farce, purportedly all about striking back at a corrupt Democratic Political Machine, which itself was, and still is, a major partner with the Republicans in the singular goal of creating a nation ruled by an alliance of corporate behemoths, and military industrial conglomerates, national and international, solely for their own benefit.
As a democracy we are done, this so called great experiment in freedom is over. We the people opened the door, aiding and abetting in our own downfall, allowing this rapacious avaricious corporate/military/industrial machine to divide, conquer, and devour us.
Of course we now know the election was a farce, purportedly all about striking back at a corrupt Democratic Political Machine, which itself was, and still is, a major partner with the Republicans in the singular goal of creating a nation ruled by an alliance of corporate behemoths, and military industrial conglomerates, national and international, solely for their own benefit.
As a democracy we are done, this so called great experiment in freedom is over. We the people opened the door, aiding and abetting in our own downfall, allowing this rapacious avaricious corporate/military/industrial machine to divide, conquer, and devour us.
Right. It's dishonest, it's cynical, it's inhumane. And it has the unanimous support of the Republican Party.
1
Isn't it great that some troll feels the need to support Trump in all of this chaos that HE created?!
He is indefensible. The GOP did not want to take up health care in this haphazard way, but Trump pushed and pushed them, knowing all along THERE WAS NO PLAN. Nice job. Doctors, hospitals, nursing homes, clinics, insurers, states, and US citizens are overwhelmingly NOT in favor of repealing the ACA and the daily seesaw is causing unnecessary stress throughout America. Trump does not care. Pence does not care. The Russians like it very much. Got it?
He is indefensible. The GOP did not want to take up health care in this haphazard way, but Trump pushed and pushed them, knowing all along THERE WAS NO PLAN. Nice job. Doctors, hospitals, nursing homes, clinics, insurers, states, and US citizens are overwhelmingly NOT in favor of repealing the ACA and the daily seesaw is causing unnecessary stress throughout America. Trump does not care. Pence does not care. The Russians like it very much. Got it?
6
Thank you for this summary and analysis. I wish Democrats could be as cogent as Mr. Edsall.
3
Health insurance is not affordable, because healthcare is not affordable. That is the real issue.
3
And NO ONE is talking about that!
A single-payer plan is the only solution: improving/tweaking ACA will not work as Repub terrorists (and insurance companies) have so many ways to gut it, as this article tells us. A national single-payer is the best among all options: Ken Arrow thought so (https://promarket.org/there-is-regulatory-capture-but-it-is-by-no-means-... Warren Buffet supports it (not because he is a "socialist")
majority of Americans support it. If Dem party adopts it they will win elections. Will they? I doubt
majority of Americans support it. If Dem party adopts it they will win elections. Will they? I doubt
5
I believe we will get there after several iterations - it's the natural landing place. Not being an expert, I have several questions though: ultimately, the prices being charged for healthcare related services in this country are obscene. Will the current crop of American doctors and hospitals work for less? Does going to a single-payer system actually require them to work for less? How many taxes need to be collected to support a system as large as single-payer if we can't drive down the cost of the underlying care?
For those of us who do not identify with either party, this health care debate fiasco in Washington is beyond disturbing. It appears that the Republican Party is willing to let people die in order to protect their ideological view. Let us be honest here. The Republicans never had any ideas about health care in America, other than the fact that they hated the ACA. Because -- "Government = BAD".
When is someone going to acknowledge reality? Health care has improved so radically in the past several decades, that maladies for which there was no hope now have treatment protocols. Many of which are extremely expensive. Americans are living longer because of available drugs and geriatric care. Again, this costs money. And research goes on. In a way, our health care system is a victim of its own success.
But this success brings with it a moral problem. Who should be allowed access to these high cost treatments and care? Everyone? People who can afford to pay for it? People who have a good enough employment situation to be able to afford health insurance (but when their insurance cap is reached, their treatment must end)? And all of this is further complicated by the fact that technological advances mean fewer and fewer people are needed in the work force. At least in the work force that offers health insurance.
Unfortunately for the Republicans, their ideology is hitting reality, like the Titanic hit the iceberg.
When is someone going to acknowledge reality? Health care has improved so radically in the past several decades, that maladies for which there was no hope now have treatment protocols. Many of which are extremely expensive. Americans are living longer because of available drugs and geriatric care. Again, this costs money. And research goes on. In a way, our health care system is a victim of its own success.
But this success brings with it a moral problem. Who should be allowed access to these high cost treatments and care? Everyone? People who can afford to pay for it? People who have a good enough employment situation to be able to afford health insurance (but when their insurance cap is reached, their treatment must end)? And all of this is further complicated by the fact that technological advances mean fewer and fewer people are needed in the work force. At least in the work force that offers health insurance.
Unfortunately for the Republicans, their ideology is hitting reality, like the Titanic hit the iceberg.
2
Everyone knows Obamacare was designed as a transition into state run health insurance. It was supposed to fail about now to precipitate a "crisis" that a Democrat president like Hillary would use to give us the next stage. They didn't expect Trump to win. Simple as that.
2
Many Trump voters reliant on ACA convinced themselves he wouldn't take their coverage. What WERE they thinking?!!
5
Mr. Edsall's detailed article makes clear the technical and administrative vulnerabilities of the ACA, and there are many. Because of its complexity, the system can be destroyed simply by deliberate poor management and neglect, and that's what Republicans will, in the end, probably do, effectively killing the ACA, slowly but surely.
It didn't and doesn't have to be that way. The beauty of Medicare for All is its simplicity. Everybody is covered. You can go to any doctor anywhere in the US; there are no networks. It's simple to get into. Enrollment could be automatic at birth or upon receiving a social security number. Its financing is entirely tax based. If you have income in America, you are supporting it. There's no debate about what the cut for private insurance should be.
Any effort to sabotage Medicare for All would be as obvious as any efforts to weaken Medicare for seniors are today, and would be resisted by the general populace just as strongly.
With Medicare for All and its simplicity and transparency, its opponents couldn't get away with "death by a thousand cuts" which Mr. Edsall documents so well.
It didn't and doesn't have to be that way. The beauty of Medicare for All is its simplicity. Everybody is covered. You can go to any doctor anywhere in the US; there are no networks. It's simple to get into. Enrollment could be automatic at birth or upon receiving a social security number. Its financing is entirely tax based. If you have income in America, you are supporting it. There's no debate about what the cut for private insurance should be.
Any effort to sabotage Medicare for All would be as obvious as any efforts to weaken Medicare for seniors are today, and would be resisted by the general populace just as strongly.
With Medicare for All and its simplicity and transparency, its opponents couldn't get away with "death by a thousand cuts" which Mr. Edsall documents so well.
3
An your version of Medicare For All, would it share with the current version of Medicare the requirement that participants pay into the system until age 65 before receiving a benefit? And that they receive no benefit whatsoever they do not do not contribute ?
Sometimes the the left goes a little too far down the dishonesty road in selling their expansive schemes. Do we really want more honesty of the "if you like your doctor..." sort? Should we take the advice of people who have such a low regard for your intelligence?
Let's not even dream that these people will admit that medicare for all is de facto the government taking over control of all healthcare in this country and dictating what care you cam receive, as did the British system this last week when it declared that an infant must die.
Sometimes the the left goes a little too far down the dishonesty road in selling their expansive schemes. Do we really want more honesty of the "if you like your doctor..." sort? Should we take the advice of people who have such a low regard for your intelligence?
Let's not even dream that these people will admit that medicare for all is de facto the government taking over control of all healthcare in this country and dictating what care you cam receive, as did the British system this last week when it declared that an infant must die.
1
I have lots of questions as well, but let's not pretend that the insurance company controlled healthcare system we currently have is benevolent. Unless you can pay your own freight, insurance companies and medicare make decisions for you - NOT always the doctor. They limit the number of days of hospital stays, and the types of treatments you will be approved for (remember, pre-approvals still apply). It's nice to rail against the government, but the consumer abuses heaped on the American public by insurance companies is brutal.
1
Ydm92,
You're absolutely right about insurances getting in the way between patient and doctor. No where is that abuse greater than in networks, where the insurance company restricts your choice of doctors.
Medicare for All has no networks. You can go to anybody who is a licensed doctor.
And yes, even Medicare for All will have its rules and restrictions, just like current Medicare for seniors does. But at least in a government run Medicare for All program, I have 2 US Senators and one Congressman to represent my views. In private insurances, I have zero representatives.
You're absolutely right about insurances getting in the way between patient and doctor. No where is that abuse greater than in networks, where the insurance company restricts your choice of doctors.
Medicare for All has no networks. You can go to anybody who is a licensed doctor.
And yes, even Medicare for All will have its rules and restrictions, just like current Medicare for seniors does. But at least in a government run Medicare for All program, I have 2 US Senators and one Congressman to represent my views. In private insurances, I have zero representatives.
Our only hope is that when Trump and the GOP have destroyed the health insurance industry, we will, at long last, demand single-payer Medicare for All. Imagine the shock when Americans discover they've been the victims of shoddy insurance, overpriced and low quality health care for all these years. It might make the French Revolution look tame by comparison. "Let them eat healthcare" as Trump might suggest. It'll be wonderful. That I can tell you. Thank you.
2
Single payer in a country of 330 million people will be a total disaster.
Have you even noticed how Charlie Gard was treated in the UK...took him away from his parents care even though they raised enough money to get him care in the U.S. The parents lost control of their own child's health care.
People are left to die in the hallways if they are too old or too sick since they only feel like young people deserve health care.
NOTHING is good about single payer and in a country with 330 million it would be beyond a disaster.
Have you even noticed how Charlie Gard was treated in the UK...took him away from his parents care even though they raised enough money to get him care in the U.S. The parents lost control of their own child's health care.
People are left to die in the hallways if they are too old or too sick since they only feel like young people deserve health care.
NOTHING is good about single payer and in a country with 330 million it would be beyond a disaster.
1
Why play all these games when we know that in the end the solution to this mess will be single payer?
4
Sorry. Meant to write brakes, not breaks.
And don't forget that for the Republicans, Medicare and Social Security are their real targets.Their assault on America and the ACA is only the first step.
AARP analysis puts it in sharp focus
"Senate Leaders Still Intent on Slashing Your Health Care"
http://www.aarp.org/politics-society/advocacy/info-2017/senate-rejects-h...
And an very good analysis of how the ACA and Medicare are intertwined
"Why Medicare Matters"
http://www.aarp.org/politics-society/advocacy/info-2016/why-medicare-mat...
Attacking Medicaid is easier...why expect the GOP to care about the unfortunate--no taxes to cut for them.
AARP analysis puts it in sharp focus
"Senate Leaders Still Intent on Slashing Your Health Care"
http://www.aarp.org/politics-society/advocacy/info-2017/senate-rejects-h...
And an very good analysis of how the ACA and Medicare are intertwined
"Why Medicare Matters"
http://www.aarp.org/politics-society/advocacy/info-2016/why-medicare-mat...
Attacking Medicaid is easier...why expect the GOP to care about the unfortunate--no taxes to cut for them.
7
Let's stop with the hypocrisy. Until the lawyers are completely removed from health care, costs will not drop significantly. Should be no lawsuits, ever, if healthcare is going to be free or subsidized. Until lawyers are removed, neither party can claim the moral high road.
3
Well, Obamacare's complexity is one of its flaws. This piecemeal attack is an example of that. The insurance racket generally is infested with people and companies who exploit the fine points of insurance to chisel bucks out of the process for themselves. Obamacare is vulnerable to damage from people with that sort of skills and experience.
It's a lot harder to gradually grind down and erode a simple program like Social Security, for example ... they obviously would like to eliminate it, but even touching it would be too obvious because it's so simple. This thing, you can climb up through the ventilation system and start messing with little control panels and what have you and gradually mess it up.
It's a lot harder to gradually grind down and erode a simple program like Social Security, for example ... they obviously would like to eliminate it, but even touching it would be too obvious because it's so simple. This thing, you can climb up through the ventilation system and start messing with little control panels and what have you and gradually mess it up.
3
The small, cold comfort I hold onto is that the near-certain demise of the ACA that results from Republican sabotage, intentional neglect, or legislative idiocy might, MIGHT, come back to haunt them, and that enough voters in the criminally gerrymandered states MIGHT turn on their Republican "saviors" and elect Democrats who actually care about their welfare. But I'm not optimistic. Somehow, Trumpers find a way to blame everyone but their party and their king... er, president.
4
This attempts to destroy Obamacare on idealogical grounds is misguided and cruel. The irony is that many Republican supporters and voters will be significantly impacted by these actions. Do Republicans not care about their voters? And this latest *Skinny bill" being considered by Republicans in the senate makes no sense on policy or moral grounds. We the people have a right to stop this assault on the poor and marginalized. I call upon the "Blue color Republican voters" to speak up and stop this mean spirited plan!!
I realize the Republicans do have a diminished mental capacity but they do have the ability to understand the consequences of their actions. Therefore, they know they will cause great harm to millions of people if they sabotage the ACA just to prove a point who"s only point is to prove a lie. Despicable is too kind a word to describe their actions, when fixing the ACA's problems would be very simple and have a lot of Democratic support.
5
Thank you for detailing the Republican plot to kill Obamacare. You need to get the TV news and opinion guys to talk back to every Republican they interview on their shows when they throw off the lines, "death spiral", "collapsing", "failing" with all their "supporting evidence" of "not one single insurer in the exchanges," etc. etc. The news media have allowed Republicans to create a false picture of a "failure" they themselves engineered. It is truly evil what they have done. So now, Democrats must fight fire with fire. They need to flood the airwaves with ads casting Republicans as liars and killers, not of the poorest and people of color because white Americans' hearts have been hardened against those groups, but of the white working class who can't get private insurance through employers or lose it when they are fired. Focus exclusively on those white faces in the mining towns, those independent plumbers, auto mechanics, small farmers and ranchers, independent truckers. home healthcare aides, childcare providers. Show what happens when people get laid off their good jobs and lose their employer-subsidized coverage. I would give my widow's mite to such an ad campaign by the Democratic Party. Do Democrats have any fight in them? They need to bring it on.
5
It's the Affordable Care Act, not "Obamacare," a term which was created by the right-wing as an insult. Why do the corporate media persist in using this term without referring to the various Republican proposals to deprive millions of Americans of health insurance as "Trumpcare?" Why do the media seem only to respond to right-wing attempts to "play the referees," which they've been doing for ages?
6
Trump wants to destroy ObamaCares for no other reason than it has his most hated nemesis name on it, the beloved President Obama.
Trump takes a lesson from the book of Russian dictators, tyrants who Trump admires, for their strength and stamina and vicious way in which they eliminate people, by liquidation, or if they allow their foes to live, by making them non-persons. Trump loves this way of "governing". And that is why I think Trump's "talents" are being wasted as president of the United States. He's make a much better, fantastic, tremendous, leader of the dictatorship. He likes the blokes ruling North Korea, the Philippines, but most especially, Russia. And so I suggest Trump hop on board Air Force One, set course for Moscow, and defect. That's right, let's put Trump where he is most comfortable, hanging with Eddy Snowden in the Presidential Suite at the Moscow Trump International. Home sweet home. We'll hardly know he's gone.
DD
Manhattan
Trump takes a lesson from the book of Russian dictators, tyrants who Trump admires, for their strength and stamina and vicious way in which they eliminate people, by liquidation, or if they allow their foes to live, by making them non-persons. Trump loves this way of "governing". And that is why I think Trump's "talents" are being wasted as president of the United States. He's make a much better, fantastic, tremendous, leader of the dictatorship. He likes the blokes ruling North Korea, the Philippines, but most especially, Russia. And so I suggest Trump hop on board Air Force One, set course for Moscow, and defect. That's right, let's put Trump where he is most comfortable, hanging with Eddy Snowden in the Presidential Suite at the Moscow Trump International. Home sweet home. We'll hardly know he's gone.
DD
Manhattan
2
All legislation - especially major legislation - should be passed with at least a minimum of bipartisan support. Expecting the GOP to do anything to help sustain Obamacare is pure idiocy.
Let Obamacare kill itself, which it will. Then, if legislation can be crafted with bipartisan support, great. If not, so be it.
Let Obamacare kill itself, which it will. Then, if legislation can be crafted with bipartisan support, great. If not, so be it.
2
Edsall makes at least two key errors:
1. Tax and Spend - Edsall quotes Kristol from 20 years ago worried about the popularity of redistribution policies and applies it to the present day. "It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests" But it misses a key point that Obamacare does NOT "protect middle class interests". Medicaid is limited to those who earn < 138% of FPL and even the Exchanges focus on those with on average income of 160% of FPL - about $18,000. Liberals may favor spending on the poor - but call it what it is. It's not middle class.
2. Medicaid - "The rejection of Medicaid expansion by 19 states ... to cover individuals making up to 138 percent of poverty level income meant that these individuals had to turn to “Health Insurance Marketplaces” or “private insurance risk pools.” That's just factually untrue and is actually corrected by the Senate version. Obamacare did not provide any subsidies to those with income < 138% of FPL. So when Medicaid was not an option, they simply went without insurance. By contrast, the Senate version now provides significant tax credits for those with incomes starting at $0 - helping to move the Medicaid population (where it's tough to find a doctor) towards private insurance like most of the rest of America.
1. Tax and Spend - Edsall quotes Kristol from 20 years ago worried about the popularity of redistribution policies and applies it to the present day. "It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests" But it misses a key point that Obamacare does NOT "protect middle class interests". Medicaid is limited to those who earn < 138% of FPL and even the Exchanges focus on those with on average income of 160% of FPL - about $18,000. Liberals may favor spending on the poor - but call it what it is. It's not middle class.
2. Medicaid - "The rejection of Medicaid expansion by 19 states ... to cover individuals making up to 138 percent of poverty level income meant that these individuals had to turn to “Health Insurance Marketplaces” or “private insurance risk pools.” That's just factually untrue and is actually corrected by the Senate version. Obamacare did not provide any subsidies to those with income < 138% of FPL. So when Medicaid was not an option, they simply went without insurance. By contrast, the Senate version now provides significant tax credits for those with incomes starting at $0 - helping to move the Medicaid population (where it's tough to find a doctor) towards private insurance like most of the rest of America.
3
Of course they're Killing Obamacare Softly.
But only because they've successfully killed the national IQ through decades of carefully cultured racism, homophobia, religious bigotry, spite, xenophobia, paranoia and spoonfed ignorance that has produced a nation of proud, angry morons who've been lobotomized for the billionaire class.
The Party of Greed and the Party of Stupid are identical, psychopathic Siamese twins thrilled to kill Americans for a few extra dollars.
But only because they've successfully killed the national IQ through decades of carefully cultured racism, homophobia, religious bigotry, spite, xenophobia, paranoia and spoonfed ignorance that has produced a nation of proud, angry morons who've been lobotomized for the billionaire class.
The Party of Greed and the Party of Stupid are identical, psychopathic Siamese twins thrilled to kill Americans for a few extra dollars.
25
Voters repeatedly have favored plutocrat demagogues. Granted Hillary Clinton's fly over debacle in 2016 greased the tracks for the Greed is Good Republicans to finally sink their teeth into the billions of dollars going into supporting the ACA and Medicaid expansion. Trump who was champion of big mouth wing of white outrage certainly sold the idea that the ACA was a program for "those people" not "us". Now the Republicans are staring in the face of historic political defeat.
6
The issue seems to revolve around the mandate, which to his chagrin (since he said it wasn't necessary when campaigning against Hillary) Obama finally concluded it was necessary so that the risk pool would be fiscally sound. The republican's repeal lite will severely damage the risk pool. So while healthy young people will have the "freedom" to buy limited coverage without true catastrophic health care, the rest will have zero choice. This failure to acknowledge the reality of healthcare, and to focus on the false belief that government mandates eliminate choice will be felt by many.
3
How about this. If the GOP wants to restore "freedom and liberty" by ending the ACA mandate, how about we restore "freedom and liberty" to hospital emergency rooms and end the mandate to treat poor, uninsured people? Why should hospitals be forced to deliver a service without compensation? Then we could watch the stark reality of life and death and misery without universal coverage. Having the emergency room as a last resort is NOT REMOTELY adequate medical care. The only way to get medical costs down is through big risk pools, financial accountability, and highly effective preventive care. The biggest risk pool would be something like "Medicare for all". Regarding preventive care, personal responsibility for healthy living is extremely important and doctors should be compensated, at least partly, on healthy outcomes.
13
Sorry, Fuzzy but, none of that will actually reduce medical costs over the long run. Maybe insurance costs but, not medical costs. The only two things which will really make medical costs lower are: First, a radical change in food production and consumption habits leading to a meaningful reduction in obesity and other associated maladies. That, coupled with meaningful daily exercise in the middle and older-aged population would also greatly reduce expensive to treat age-related mobility and other issues in the elderly. And, secondly, an end to our cultural need to chase a couple of extra months of extra survival time during our inevitable end-of-life decline. The vast majority of hospital medical expenses are spent in that futile quest.
Other than addressing those issues, all the rest of the debate is really about who pays.
Other than addressing those issues, all the rest of the debate is really about who pays.
2
You do realize that Medicare is unsustainable.
In its current form it will bankrupt the country by 2042.
We will not have the money.
This was the plan with the implementation of the ACA. From the rollout to the exchanges it was built to rip our economy out from under us.
It's Progressive politics aimed to destroy the republic.
This is not an emotional issue, it's an issue of economics.
Our need to help cover everyone is altruistic and laudable but it is a pipe dream that's impossible to manufacture.
Some dreams are worth chasing, but when the dream becomes a nightmare, and leads to economic ruin, which it will, we have to have the fortitude to change.
In its current form it will bankrupt the country by 2042.
We will not have the money.
This was the plan with the implementation of the ACA. From the rollout to the exchanges it was built to rip our economy out from under us.
It's Progressive politics aimed to destroy the republic.
This is not an emotional issue, it's an issue of economics.
Our need to help cover everyone is altruistic and laudable but it is a pipe dream that's impossible to manufacture.
Some dreams are worth chasing, but when the dream becomes a nightmare, and leads to economic ruin, which it will, we have to have the fortitude to change.
2
You're right about Medicare being unsustainable. The bankruptcy part is debatable, as is the assertion that that particular train left the station with the ACA. I work in financial services, and Medicare is the best insurance many of my clients have ever had. It pays for everything. It was also designed for a population that had much lower mortality tables than we have now, at a time when disease treatment and prolonging life were not an area of focus for the elderly. Medicare (and Social Security, for that matter) would be sustainable if our country would make pragmatic, bi-partisan concessions to make them sustainable, but no one will touch it. It's easier to slash and burn Medicaid coverage because it's a population with a much smaller voice. We as citizens need to understand that 1) All of our health care coverage is subsidized, whether it's directly through government programs or through tax write-offs; 2) If we're going to cover everyone, we may need to decide if we're going to pay for a 90 year-old to go through chemotherapy treatments; 3) We need to recognize that one way or another, we're paying for it.
2
Bad idea to pass Obamacare without any Republican votes. Bad policy to discuss "X million people will lose coverage" without discussing what else they may be doing with their money. I believe that the only way for any nationalized health care to work financially is for someone in the position of "big brother" to decide what is paid for and what is not, and that is UN-American.
3
The Republicans simply refused to participate, even as the conservative plan embodied in the Affordable Care Act was passed. In their refusal the Republicans blatantly vaulted partisan political interests far above the national interest. It wasn't the first time nor will it be the last time that the Republicans do that. If people need health care, what else might they do with their money? Buy hockey tickets? We're talking about money which will be spent on healthcare.
4
President Obama and the Democrats outsmarted the GOP with the Affordable Care Act. Many red state governors sabotaged their constituents by refusing expanded Medicaid. I doubt return to an open market with no ACA would help the families who have seen premiums skyrocket. Insurance will continue to be expensive because there are no breaks on the profiteering of health care providers.
Expand Medicare for all. Stop the price gouging of necessary treatments and
pharmaceuticals.
Expand Medicare for all. Stop the price gouging of necessary treatments and
pharmaceuticals.
6
Obama didn't outsmart anyone. They lied about its sustainability and they pulled the wool over the eyes of the naysayers with the lie.
It was never supposed to succeed.
Where we are today is exactly where the Obama administration wanted to go.
Republicans have the upper hand but their
leadership is supine.
Having the majority was what they told the voter they needed. They never in their wildest dreams thought Trump would win.
Now that he has, they are afraid to lead.
It's shameful.
It was never supposed to succeed.
Where we are today is exactly where the Obama administration wanted to go.
Republicans have the upper hand but their
leadership is supine.
Having the majority was what they told the voter they needed. They never in their wildest dreams thought Trump would win.
Now that he has, they are afraid to lead.
It's shameful.
2
Well, they also never thought their own base would balk. That is the ONLY reason they are attaching a replace option to the repeal effort. For 7 years they voted to repeal about 50 times. NOT ONCE were the votes accompanied by a replacement. They could care less about a healthcare bill.
The Trump/GOP propaganda machine will try to convince the Obamacare recipients that this is collapsing on its own. Another Trump/GOP lie. The GOP tell the public that health care is too expensive, but do not want to look into the system to find out why. Their solution is to eliminate Obamacare entirely. For the wealthy, a good solution. For the less fortunate and elderly, not so good.
2
There is no conservative health care proposal that would be broadly popular and, if fully understood, politically acceptable. Hence the underhanded/brainwash action; the fundamental platform is opposition to the very intent of public policy.
11
More likely, President Trump's conservative ambition is the destruction of any policy President Obama instituted.
1
Moral outrage is good if it keeps the fires of opposition burning. We owe a debt of gratitude to Thomas Edsall for his many incisive explorations of right-wing thinking and strategy, and the moral outrage they engender within us.
Moral outrage is good until it becomes a distraction. Moral outrage is good, but it is not a substitute for strategy. With the country on the brink of authoritarian rule, we must go beyond outrage. We must think anew, and act anew.
What does that entail? As a starter, it means willingness to talk here and elsewhere about strategy, specifically how Democrats can win in 2018, and take back one or both houses of Congress. If the Democrats fail to do so, democracy, now on life support, will almost surely die in this country.
What can you do? Here’s an online email I sent to my congresswoman and two senators, yesterday. For starters you can do the same. Feel free to use my wording:
"A Better Deal" is too narrowly drawn. Yes, we need the working-class, but we also need all those people who didn't vote in 2016, whose numbers far exceed the working-class defectors. To win in 2018 we need a broad, compelling vision of America, one that appeals across race, class and ethnicity. Above all, we need single-payer. This narrowly drawn platform will not inspire victory in 2018."
Here are some numbers about who voted in 2016, and who didn’t:
•The Democratic Party’s Billion-Dollar Mistake, Steve Phillips, NYTimes, July 20, 2017, http://tinyurl.com/y9wcleng
Moral outrage is good until it becomes a distraction. Moral outrage is good, but it is not a substitute for strategy. With the country on the brink of authoritarian rule, we must go beyond outrage. We must think anew, and act anew.
What does that entail? As a starter, it means willingness to talk here and elsewhere about strategy, specifically how Democrats can win in 2018, and take back one or both houses of Congress. If the Democrats fail to do so, democracy, now on life support, will almost surely die in this country.
What can you do? Here’s an online email I sent to my congresswoman and two senators, yesterday. For starters you can do the same. Feel free to use my wording:
"A Better Deal" is too narrowly drawn. Yes, we need the working-class, but we also need all those people who didn't vote in 2016, whose numbers far exceed the working-class defectors. To win in 2018 we need a broad, compelling vision of America, one that appeals across race, class and ethnicity. Above all, we need single-payer. This narrowly drawn platform will not inspire victory in 2018."
Here are some numbers about who voted in 2016, and who didn’t:
•The Democratic Party’s Billion-Dollar Mistake, Steve Phillips, NYTimes, July 20, 2017, http://tinyurl.com/y9wcleng
2
This was never about "killing Obamacare Softly," the title of this commentary notwithstanding. This has always been about taking a sledgehammer to the lives of upwards of 50 million Americans, depending upon which swing of the sledgehammer the GOTP nihilists have wielded. Let us distill things down to a few basics: (a). The GOTP is attacking its own Heritage Foundation/Romneycare platform. (b.) The are doing (a) because they were enraged that a Democratic, African American President proposed their own platform. (c) They despise and seek to crush women's healthcare privacy ajd primacy, and reduce us to 2nd class procreative chattel under the bootheels of patriarchal white male religious misogynists. (d) They loathe and condescend to the poor and struggling working classes, and do not believe that there is any moral obligation to help the least among us. (e) They seek at all costs to shower hundreds of billions of dollars upon the wealthiest plutocrats who own them. (f) They wanted to stick it to President Obama and to Democratic voters in every red state. (g) They'e got theirs, and they don't care at all about those who don't have what they do. Anything else is merely window dressing. Finally: His Fraudulence (Drumpf) despises President Obama and is pathologically obsessed with nullifying him - in that, he has an entire party of willing accomplices. Welcome to the resurgence of the Confederate 1800's, folks. 7/27, 10:27 AM
7
Republicans don't care.
Got that?
Got that?
5
Robert FL,
I wonder how much or for whom the Democrats cared in 2009 and 20010 when they had both houses of Congress and the presidency, and the best they could give us is the byzantine, convoluted, complex ACA.
Those Democrats obviously cared a lot about the well being of private insurances when they gave private insurances generous subsidies, even as private insurance executives earned millions yearly.
I wonder how much or for whom the Democrats cared in 2009 and 20010 when they had both houses of Congress and the presidency, and the best they could give us is the byzantine, convoluted, complex ACA.
Those Democrats obviously cared a lot about the well being of private insurances when they gave private insurances generous subsidies, even as private insurance executives earned millions yearly.
2
Democrats don't care.
Got that?
Got that?
1
"...legislation that makes federally financed health care more broadly available..."
But does so by screwing those forced to pay higher taxes, higher premiums, and higher deductibles. This is astonishingly unjust.
I don't care whether Obamacare dies gently or in agony as long as it dies and puts itself out of the country's misery.
But does so by screwing those forced to pay higher taxes, higher premiums, and higher deductibles. This is astonishingly unjust.
I don't care whether Obamacare dies gently or in agony as long as it dies and puts itself out of the country's misery.
4
Medicare for all is the only answer.
3
It is unjust. This is why we need single payer so all will be treated equally.
Under single-payer, people who actually pay taxes are forced to pay everyone's bills while those those who pay little or no tax get "free" medical care. The is not "treating everyone equally."
1
To soften the blow to 30 million Americans losing health coverage,Tom Price, Paul Ryan and Mitch McConnell are offering an inexpensive cremation plan that can be used at the funeral home of your choice.
6
Make no mistake, Obamacare is a hideous racket that is only concerned about profits. Fixing it is putting lipstick on the pig. However, if you listen closely you can hear a grunting snorting 800-lb porker on the horizon that will devour the entire budget - the GOP 'plan'
4
Killing Obamacare softly like the song says...Yes, Yes, and Yes!!!!
2
Killing Obamacare Softly, along with everything and everybody else.
3
Trump is hell bent on destroying the GOP. He is a man of no party. Trump cares only about his bottom line. As a Democrat, I believe we need a healthy Republican Party for our government to work. Resist Trump.
2
Resistance is a waste of time.
The people have decided to head down this path.
Progressivism has worn out the electorate.
Our Democrat party has gone over the cliff.
Trump, like him or not, hit a vein of populism that will move the electorate back to the center.
It's causing a purge of the party to rid the infection of Marxism that Progressives injected into it in the 1920's.
The people have decided to head down this path.
Progressivism has worn out the electorate.
Our Democrat party has gone over the cliff.
Trump, like him or not, hit a vein of populism that will move the electorate back to the center.
It's causing a purge of the party to rid the infection of Marxism that Progressives injected into it in the 1920's.
The republicans want their tax cuts for the rich - the rest of the country be damned. Their quest is akin to that of a sociopath.
3
OK so Democrats would protect the middle class by passing laws that provide benefits and support in such areas as affordable or even ()gasp!) free health care, safer communities, good education for all.
The Republicans would protect the middle class by taking away regulations so corporations can pollute the environment and screw consumers, and by getting rid of health care for anyone who can't afford it, and by pushing resources into schools in wealthy neighborhoods and leaving public schools dangling.
OK, thanks. Now I see why middle class voters support the GOP.
The Republicans would protect the middle class by taking away regulations so corporations can pollute the environment and screw consumers, and by getting rid of health care for anyone who can't afford it, and by pushing resources into schools in wealthy neighborhoods and leaving public schools dangling.
OK, thanks. Now I see why middle class voters support the GOP.
4
Since it's clear trump has strong middle class support maybe you should reexamine your premises as clearly you've erred somewhere.
Corporations are not inherently evil thieves robbing the poor and polluting the lands. Most have good relationships with their employees, customers and workers.
On education, while you are correct the democrats have tried to redistribute funding to poorer areas, they have shown no gains in actual education as a result. Democrats ignore any consideration of structural change in education because the teachers union has no interest in it. The populous sees though this canard.
Corporations are not inherently evil thieves robbing the poor and polluting the lands. Most have good relationships with their employees, customers and workers.
On education, while you are correct the democrats have tried to redistribute funding to poorer areas, they have shown no gains in actual education as a result. Democrats ignore any consideration of structural change in education because the teachers union has no interest in it. The populous sees though this canard.
3
Obama and Crooked Hillary spent eight years trying to destroy America!
President Trump stands behind what's good for America!
Thank God for President Trump!
America First!
President Trump stands behind what's good for America!
Thank God for President Trump!
America First!
5
I hope this is sarcasm. If not, "heel" is advocating class warfare started by the GOP and Trump. People will not stand by and lose something they need for an adequate life.
1
Throwing people off heath care is good for America?
Please provide something more than empty assertions; hype may be good enough for TV & commercials, but it is lousy when providing life-saving health insurance to 200 million Americans.
1
Who are you people to deny health care, obsfucate, lie and generally reveal yourselves as victims of lead in the water? Some rare disease? Where are your principles, ethics? Oh I forgot, business is business.
3
Health Care is not a right!
To conscript a person and indenture them to your whims is the folly of Marxism.
The USA is a constitutional republic, if we can keep it!
The line has been drawn, and I for one, am glad it's been crossed.
To conscript a person and indenture them to your whims is the folly of Marxism.
The USA is a constitutional republic, if we can keep it!
The line has been drawn, and I for one, am glad it's been crossed.
2
This ought to be the lead story, rather than the ongoing irrelevant garbage coming out of Trump's mouth.
6
From your lips to God's ear, or at least to the ears of the powers that be at CNN, PBS News Hour and MSNBC.
Every story on these outlets now begins "President Trump..."
Ignore the dimwit and move on to what is happening under his administration.
He's too dumb to be much harm, but Sessions, Perry, Carson and the rest of his crew are the ones with the bloody knives.
Every story on these outlets now begins "President Trump..."
Ignore the dimwit and move on to what is happening under his administration.
He's too dumb to be much harm, but Sessions, Perry, Carson and the rest of his crew are the ones with the bloody knives.
1
Death by a thousand cuts.
7
Death by a thousand cuts works just as effectively as a beheading. Donald Dubious has delightedly said that Obamacare will self destruct. Of course, President Snowflake will starve it to death and then ask us to condemn the victim for missing meals.
5
This is valuable information which the GOP has made irrelevant... the anti party... only knows how to raise fear and anger... unfortunately the Dems aren't using these teachable times. They have also been disassembled and it is partly their fault for being naive and stupid and blind.
4
Re: Bill Kristoll and “security”:
Americans believe in “life, liberty, and the pursuit of happiness,” often at other people’s expense. The French believe in “liberté, égalité, fraternité”—liberty, equality, and fraternity, which together promote citizenship. The Swedes believe in “frihet, jämnlikhet, trygghet”—liberty, equality, and security, which together promote a good quality of life. Americans need to rethink the American experiment.
Americans believe in “life, liberty, and the pursuit of happiness,” often at other people’s expense. The French believe in “liberté, égalité, fraternité”—liberty, equality, and fraternity, which together promote citizenship. The Swedes believe in “frihet, jämnlikhet, trygghet”—liberty, equality, and security, which together promote a good quality of life. Americans need to rethink the American experiment.
5
Under Tom Price and this 'Rump Administration, it's more like "Department of Death and Human Sacrifices."
2
Whatever Republican do to kill Obamacare, they will own it as will Trump. And when his supporters begin to feel the true horrors of Trumpcare, their fury will know no bounds. Watch out what you wish for, GOP!
4
It's about Obama, but depriving people of health care is icing on the cake for the GOP.
They still want to delegitimatize Obama for daring to be president. The nerve of that black man being in the GOP White House!
They still want to delegitimatize Obama for daring to be president. The nerve of that black man being in the GOP White House!
3
GOP is the anti-people party. Let's hope the people can see it.
4
U.S. used to stand for United States.
Now it stands for Unseen Sabotage
Keep on publishing these columns NYT so the sabotage can become public knowledge. and not unseen.
Now it stands for Unseen Sabotage
Keep on publishing these columns NYT so the sabotage can become public knowledge. and not unseen.
6
Let's keep the 20 million that were uninsured before, insured; I am good with that. And for the Democrat's and their left wing supporters who rammed ACA through, who were and are intellectually superior enough to know that it was absolutely not going to deliver lower costs and the ability to keep my doctor and, most of all, Republican cooperation in the future, why don't you pay for my middle-class healthcare insurance. Right now, it is virtually useless with the massively higher deductibles and premiums. And why don't you have the Democrat's who rammed ACA through, with at best 36% public approval, in order to buy the +20 million votes, be forced to live solely with ACA healthcare plans? Where is the liberal progressive outcry? Now you guys (I am an independent) caused America the worst president ever, Trump. Trump is the reality now - he is real, get it? And the reality is Obamacare is a disaster by Democratic design. And it was their choice, as well as many of the readers here, to ignore the rest of America just so their party could "win" with Obamacare with this hidden "plan" for universal healthcare at my family's expense. It's Trump's turn at the wheel now, that's reality. If you don't like it, please serve up a better candidate and better policies next time, as opposed to an extension of stale failed Obama policies via Clinton that cost my family dearly.
2
Your family would benefit from Medicare for all. But the Dems are beholden to Big Insurance and Big Pharma.
Funny, even O acknowledged that ACA wasn't a finished product and that it would need continued tweaking at the state level in order to make it accessible and affordable. Unfortunately, a good number of red states had a temper tantrum and decided to reject the possibility of participating...and of course, we have those bold 'publicans who haven't a clue as to how to fix this, even though it was originally Romney care and did pretty well in Massachusetts. As has been remarked above by several other commentators, death by a thousand cuts. Well, then, let it fail and that will hopefully motivate the will to develop a single payer plan.
1
The article is full of insights. To what end? The phrase "war of attrition" perfectly describes the Republican game plan and it's working. One at a time, whether by bribes or by threats, the Republican outlyers are being picked off until at some point the Republicans can proudly say they have destroyed medical care for millions of Americans, which was always the ultimate goal. Pointing that out won't serve any purpose. I've pretty much given up and so I believe have many Americans, including those who will lose their medical care.
House and Senate Republicans can't find a reasonable solution because of their hysterical and blind hatred of President Obama and everything he accomplished.
For most of them them, purging America of the memory and legacy of Barack Obama is the most important thing no matter what the consequences.
For most of them them, purging America of the memory and legacy of Barack Obama is the most important thing no matter what the consequences.
4
The use of the term "Obamacare" has never been construed as complimentary and is not the proper name of the Affordable Care Act which, thanks to the clear racial derogation, is why the proper name is left out.
The fact this misnomer is repeated over and over to the point it is accepted in a publication of this caliber is a dismaying indication of just how the propaganda of the racists among is, however unwittingly, proselytized.
A vicious game is being played which if left unnoticed will cost all of us, including the top social tier of our nation, our freedom.
This is not a joke or oversimplification. The signs are everywhere and clearly voiced by a President who should know better than to introduce his personal management style into our political system; unless of course he has muddied thoughts of assuming a throne with his court, now well trained, sitting beside him.
The fact this misnomer is repeated over and over to the point it is accepted in a publication of this caliber is a dismaying indication of just how the propaganda of the racists among is, however unwittingly, proselytized.
A vicious game is being played which if left unnoticed will cost all of us, including the top social tier of our nation, our freedom.
This is not a joke or oversimplification. The signs are everywhere and clearly voiced by a President who should know better than to introduce his personal management style into our political system; unless of course he has muddied thoughts of assuming a throne with his court, now well trained, sitting beside him.
1
Single payer is the way to go. Calling it Trumpcare or Romneycare could be a face saving device for the Republicans.
We need bipartisanship on this important issue and not constant attacks on Trump and Republicans by the New York Times which will only continue the battle and without a ceasefire.
Let us get single payer and move ahead!
We need bipartisanship on this important issue and not constant attacks on Trump and Republicans by the New York Times which will only continue the battle and without a ceasefire.
Let us get single payer and move ahead!
3
But Hillary and Pelosi say "We can't."
The Republicans will get away with this. 40% of the country is too dense to comprehend any of it and Fox News will convince them that not having insurance gives them more freedom. The Democrats, as always, will be helpless and hapless to offer a counter narrative. How's that message rebranding go this week? Did anyone besides Schumer and Pelosi notice?
2
It is the same method they use to destroy the abortion law. They have come a long way with it, very encouraging to use the method on health care or any law they don't like. How about transgender rights and back to the rights of the LGBT people? Voting rights anyone? and on and on it goes, Trump can change the law on a daily bases, he will tell the nation via twitter what the days law is.
1
Edsall is absolutely right that the clear aim is to make Obamacare inconvenient and unworkable for its enrollees. The primary reason why it is unraveling is uncertainty, which businesses abhor. Even when rules are onerous, businesses will find ways to make them work. The constant threats to the legitimacy of Obamacare have wielded an axe to it in many markets. The real culprit, however, is the name. We must not forget that Obamacare was designed by the Heritage Foundation. But Republicans hated President Obama so much that they opposed anything and everything he proposed or crafted. Their Pyrhhic victories in incessantly voting to repeal Obamacare masked what we all suspected and now know for sure. They had no alternative plan. Their opposition was to the President, period. Now that their real enemy is gone, they are caught in the glare of truth -- Obamacare was okay; they really hated its builder. They probably never believed that they would have to actually design a system that's as complex as it seems to be -- or better stated, too complex for them. The astonishing revelation is that they hated President Obama so much that they never even contemplated these humiliating places that their Obama hate would take them.
46
Impeach now. This sabotage has to stop. This President is totally out of control.
1
With all of this talk the only thing Republicans are discussion is how many low income people can we deny health care and still get elected. For Republicans the “Great Disaster of Obama Care” is that low income got health insurance. If nothing is passed and low income people lose health care for the Republicans this will be winning.” trump could care less, instead of accomplishing, trump is constantly busy blaming others for his failures and listening to is own voice.
1
How the Republicans can sleep at night knowing they are being so cruel to so many people is mind boggling. The chaos they will cause in the insurance and healthcare market will emerge soon and they will not be able to fix the problems, but will blame Obama.
Obama's legacy cannot be harmed by Republican's destroying the ACA as history will show that Obama did the right thing. The only thing being destroyed will be the health of the people.
Obama's legacy cannot be harmed by Republican's destroying the ACA as history will show that Obama did the right thing. The only thing being destroyed will be the health of the people.
2
Single payer, enter stage right.
4
As long as the R's think they can loot more pockets without it, they will fight Obamacare just like they fought against Social Security and Medicare.
1
There are so many Republican policies for which I can't find any explanation other than sadism; the immiseration of millions of people for its own sake or vengeance against the poor and the powerless for crimes that exist only in the Republican mind. Healthcare is exhibit A.
1
In 8 years how many fixes of the ACA have Democrats proposed in congress? Don't bother looking it up, the answer is zero.
4
The Trump administration and this GOP controlled Congress have only one over-riding policy principle: If Obama did it, passed it, signed it into law, regulated it -- UNDO IT! They have no interest in actual accomplishment beyond trying to erase any and all evidence that there even was an Obama Presidency. They would like the history books to reflect an 8 year period marked with an asterisk during which the nation did not have a legitimate President.
Orwell is smiling in his grave over the irony of the U.S. Congress acting like the Ministry of Truth.
Orwell is smiling in his grave over the irony of the U.S. Congress acting like the Ministry of Truth.
2
Health care inequity enslaves the middle class and sets them against the poor, who have no hope at all. GOP likes that.
1
It is so very ironic that the GOP has fought so hard to destroy the ACA (or any government run health care, dating back to the early 1960s) because of a fear that socialism (read, Soviet socialism) would take hold in the US while simultaneously enabling a president that has fully embraced the Russian cause.
Kristol's warning is only the most recent incarnation of the socialist threat to American values and, more significantly, to the competitiveness of the Republican party.
The GOP no longer actually fears the Russians (they love them and support their drive to reestablish the USSR no doubt) but they do fear an enlightened public, aware that government can do good for its people.
Kristol's warning is only the most recent incarnation of the socialist threat to American values and, more significantly, to the competitiveness of the Republican party.
The GOP no longer actually fears the Russians (they love them and support their drive to reestablish the USSR no doubt) but they do fear an enlightened public, aware that government can do good for its people.
2
Every time some Republican comes out and says something like "Obamacare is hurting families" or mentions "thousands of victims of Obamacare" they are making invisible the other thousands of people Obamacare has helped. This is very similar to the way that Democrats trumpeted the economic recovery under Obama, but failed to acknowledge adequately the experience of those Americans who were untouched by the recovery. Those Americans rose up in voted in 2016. Maybe the same thing will happen with Obamacare. Maybe people who've been helped by it will get sick of listening to Republicans continue to talk about Obamacare victims having their lives destroyed by the law. As though those who have been helped don't exist.
1
The ACA is not sustainable - it tries to serve too many masters in terms of insurance companies, healthcare providers - physicians, facilities, etc - prioritized over people. Of course it is expensive.
The actual need is to walk back the huge financial investment that tangle up around the ecosystem of US healthcare without causing Wall St panic AND take control of our ways of delivering healthcare while minimizing the effect of private financial interests.
Optional single payer for health insurance, using existing Medicare, would be the simplest option at this point. With expansion over a period of time to allow financial institutions to adapt their business models.
If you take a lollipop from a child he'll cry, if you take a hugely profitable line of business away from Wall St you'll miss getting PAC and lobbyist money and probably other goodies while making political enemies and have to deal with angry investors.
Our government needs to have the courage and strength of focus to do this. Obama couldn't. It looks like Trump won't be able to either.
The actual need is to walk back the huge financial investment that tangle up around the ecosystem of US healthcare without causing Wall St panic AND take control of our ways of delivering healthcare while minimizing the effect of private financial interests.
Optional single payer for health insurance, using existing Medicare, would be the simplest option at this point. With expansion over a period of time to allow financial institutions to adapt their business models.
If you take a lollipop from a child he'll cry, if you take a hugely profitable line of business away from Wall St you'll miss getting PAC and lobbyist money and probably other goodies while making political enemies and have to deal with angry investors.
Our government needs to have the courage and strength of focus to do this. Obama couldn't. It looks like Trump won't be able to either.
3
You make too much sense.
Those in favor of dismantling the ACA forget that the bill for uninsured who get their healthcare from the emergency room is paid by those of us who have insurance. Like the Canadian Mounties always get their man, the insurance companies always get their money.
2
I feel sorry for people who vote against their own best interests in order to identify with a flawed, bankrupt ideology. If the republican base comes to it's senses it can rectify the situation easily. Vote for democrats.
They don't even have to admit they are doing it. They can save face and transition slowly into democrat registration, or not, as it suits the individual. Just close their eyes and think about the lie they were told by the republican leadership that upsets them most, and simply vote for a democrat. I think they will be surprised at how easy and gratifying it is. I think they will be very happy with the health coverage their family has as a result of their enlightened action. I know I have been.
They don't even have to admit they are doing it. They can save face and transition slowly into democrat registration, or not, as it suits the individual. Just close their eyes and think about the lie they were told by the republican leadership that upsets them most, and simply vote for a democrat. I think they will be surprised at how easy and gratifying it is. I think they will be very happy with the health coverage their family has as a result of their enlightened action. I know I have been.
2
Obamacare was a step in the right direction and the intentions of the legislation had merit to help those without previous healthcare coverage. Unfortunately, Obamacare and Trumpcare appear to do too little to lower or contain the costs of healthcare, only shift who pays for it. How much waste is in the current $3.2 trillion healthcare system? There is no one silver bullet, but can we identify 15 areas that could make a difference for all of us. Here’s a few topics/questions:
1) Excessive administrative costs and profits of health insurers whose stock prices have appreciated 300% or more in the last 7 years. Doesn’t the government have leverage to keep them in Obamacare markets when they profit from other government administered markets?
2)Are doctors, specialists and hospitals charging too much and prescribing too many procedures or is it due to indigent care, threat of lawsuits, cost of malpractice insurance, administrative costs and medical school tuition debt?
3)Should pharmaceutical companies make a return on equity of over 20% and do government programs that often fund research at the beginning share in any of that profit?
4)Can consumers make rational economic decisions regarding healthcare when often confronted with irrational life and death health circumstances?
5)With 5% of the population accounting for 50% for the country’s healthcare costs, can we determine if there’s a way to deliver good results more efficiently?
Because of lobbyists, we may never know.
1) Excessive administrative costs and profits of health insurers whose stock prices have appreciated 300% or more in the last 7 years. Doesn’t the government have leverage to keep them in Obamacare markets when they profit from other government administered markets?
2)Are doctors, specialists and hospitals charging too much and prescribing too many procedures or is it due to indigent care, threat of lawsuits, cost of malpractice insurance, administrative costs and medical school tuition debt?
3)Should pharmaceutical companies make a return on equity of over 20% and do government programs that often fund research at the beginning share in any of that profit?
4)Can consumers make rational economic decisions regarding healthcare when often confronted with irrational life and death health circumstances?
5)With 5% of the population accounting for 50% for the country’s healthcare costs, can we determine if there’s a way to deliver good results more efficiently?
Because of lobbyists, we may never know.
6
The Republicans are exploiting one of the disincentives to purchase any kind of insurance. Many people don't truly understand a basic issue with any type of insurance: they don't understand they need to carry insurance until they actually need it. You can drop the property or collision insurance once the underlying mortgage or automobile debt is paid off but you're then dependent on the caprices of fate to protect your investment. The Republicans are exploiting this "it won't happen to ME" attitude to convince their constituents that they don't need the protection of ACA if they have to pay any premiums for it.
3
Actually, Republicans assume that Americans are bright enough to understand the nature of insurance. It's the Democrats who, by their willingness to use coercion, express their contempt for the idea that Americans are competent to make their own decisions.
1
The republican party is nothing if not the celebration of narcissism.
1
The doleful Trump-inspired congressional beat goes on to destroy whatever health security the nation has managed to create for itself. Inartful as he was, Bill Clinton had it right when he labeled the ACA "crazy." But it has been better than any other health care policy in US history, notwithstanding the relentless GOP sabotage.
"Better," however, is a long way from "best." For that, let the civilized world be our guide. Declare access to affordable health care a core human right and adopt a sane single-payer system. Tell the special interests to get over their outrage about establishing a humane trust for American public health.
"Better," however, is a long way from "best." For that, let the civilized world be our guide. Declare access to affordable health care a core human right and adopt a sane single-payer system. Tell the special interests to get over their outrage about establishing a humane trust for American public health.
3
Isn't the biggest misconseption that Republicans have is that their hard core conservative principle of less government involvement will lead to better health care? Remove all the regulations, subsidies, taxes, mandates that are integral to Obamacare, then the freed up market place will take over, and there will be great health care for everyone.
Do they not realize that just as the federal government is deeply involved in healthcare for people over 65, the disable, and the very poor (Medicare and Medicaid) and employer supported health insurance, the federal government must become deeply involved to provide health insurance to the remaining uninsured people?
The Republicans in government need to decide whether they want to stick by their hard core conservative principle or their basic commitment to care for needs, concerns of the people who they represent. And this can be difficult if the people who voted against them are the ones with the needs and concerns, and if the people who voted for them don't care about those other people, especially difficult if the former are outnumbered by the latter.
Do they not realize that just as the federal government is deeply involved in healthcare for people over 65, the disable, and the very poor (Medicare and Medicaid) and employer supported health insurance, the federal government must become deeply involved to provide health insurance to the remaining uninsured people?
The Republicans in government need to decide whether they want to stick by their hard core conservative principle or their basic commitment to care for needs, concerns of the people who they represent. And this can be difficult if the people who voted against them are the ones with the needs and concerns, and if the people who voted for them don't care about those other people, especially difficult if the former are outnumbered by the latter.
1
The Republican's commitment is to destroy democracy, they are anarchists and Republican by name only, the GOP is really DEAD.
1
Really??? Republicans control the White House and both chambers of Congress as well as the majority of governorships and state legislatures. But keep thinking the GOP is DEAD.
The main reason that Democrats lost the House in 2010 was because Obamacare hurt the middle class. Obamacare helped the poor, but on the back of the middle class.
The main reason that Democrats lost the House in 2010 was because Obamacare hurt the middle class. Obamacare helped the poor, but on the back of the middle class.
What is going to happen is this: the Senate will pass something -- anything -- that they can label a repeal/replace. Their bill and the House bill will then go to a conference committee composed of members from the Senate and the House. Although supposedly there are myriad restrictions on what the conference committee can do in terms of changing the scope of a final bill, in practice the conference committee can come up with something vastly different than what was contemplated by either the Senate or the House. You can be sure the reconciliation proposal from the conference committee will be draconian. Then it goes back to the Senate and the House, where there will likely be insurmountable pressure on "moderates" like Collins and Murkowski to approve the new version. (This is why McCain's vote in favor of the procedural motion, which has allowed the Senate an opportunity to pass a "skinny repeal," will go down in history as the worst, most unprincipled act of his career.)
Even if the final bill passed by Congress amounts to no more than "skinny repeal," that in itself will doom the ACA by allowing healthy people to avoid getting insurance, thereby forcing premiums through the roof for unhealthy enrollees.
Even if the final bill passed by Congress amounts to no more than "skinny repeal," that in itself will doom the ACA by allowing healthy people to avoid getting insurance, thereby forcing premiums through the roof for unhealthy enrollees.
15
I agree with the premise 'killing Obamacare softly'. However, let's not use cuddly, kind words to define what they're up to. I believe it's been obvious for quite a while the Republicans have adopted the strategy of getting rid of things they don't like using the tactic 'death by a thousand cuts'. Whether it's Medicaid, Planned Parenthood, A Woman's Right to Choose, Medicare, Food Stamps, The Department of Education, take your pick. Let's call it for what it is, what they've adopted: the Republican tactic of 'death by a thousand cuts'.
20
Republicans are more committed to their cause than we Progressives are. How do I know? Because they fight much harder. If lying, manipulating and usurping is now acceptable political currency then - as difficult as it is to swallow - we must lie, manipulate and usurp. The "Weeny liberals" (a James Carville phrase) that are currently running the DNC are of no use to the ordinary hard working citizens that we are trying to help. They're hitting us below the belt and all we're doing is crying and complaining. If we don't start fighting fire with fire, our moral superiority will co-exist with 2 or 3 more Neil Gorsuch(s) and budget cuts that will inflict huge pain to many many people.
13
Trump took an oath to see that the laws are faithfully executed. PPACA is the law of the land and Republicans lack the votes to repeal it.
If he and Republicans in Congress undermine and hobble duly enacted laws, millions will lose coverage, many of them ordinary working people who don't get healthcare at work.
Trump should not surrender to pique and break his oath of office, which would bring misery to millions.
Americans deserve to have quality healthcare without regard to ability to pay. It's not something we can't afford to do. It's something we cannot afford not to do.
Unless and until Congress develops a better system (unlikely, I know), PPACA is the best we have. Team Trump needs to make it work, not sabotage it from within.
If he and Republicans in Congress undermine and hobble duly enacted laws, millions will lose coverage, many of them ordinary working people who don't get healthcare at work.
Trump should not surrender to pique and break his oath of office, which would bring misery to millions.
Americans deserve to have quality healthcare without regard to ability to pay. It's not something we can't afford to do. It's something we cannot afford not to do.
Unless and until Congress develops a better system (unlikely, I know), PPACA is the best we have. Team Trump needs to make it work, not sabotage it from within.
3
I lost you after 'Trump took an oath..'
What does that even mean?
What does that even mean?
What is surprising isn’t that Obamacare is failing. It’s surprising that Obama and DC Democrats were so naïve, ignorant, and blind to the fundamental issue killing Obamacare – that it’s needs based.
FDR didn’t make Social Security needs based. SSI is universal and therefore universally funded and supported.
LBJ and Chairman Wilber Mills didn’t make Medicare needs based. In fact, Mills took the GOP needs based Eldercare Plan meant to kill Medicare and turned it into needs based Medicaid. He then combined Medicare, Medicaid, and a 7% SSI increase and passed all three out of the Ways and Means Committee on a straight partyline vote.
Today, every American has a basic right to beneficial health care. The current for-profit, market-based insurance scheme is structurally unworkable, fiscally unaffordable, and therefore, unsustainable. Accept that as fact and pass universal Medicare-for-All.
FDR didn’t make Social Security needs based. SSI is universal and therefore universally funded and supported.
LBJ and Chairman Wilber Mills didn’t make Medicare needs based. In fact, Mills took the GOP needs based Eldercare Plan meant to kill Medicare and turned it into needs based Medicaid. He then combined Medicare, Medicaid, and a 7% SSI increase and passed all three out of the Ways and Means Committee on a straight partyline vote.
Today, every American has a basic right to beneficial health care. The current for-profit, market-based insurance scheme is structurally unworkable, fiscally unaffordable, and therefore, unsustainable. Accept that as fact and pass universal Medicare-for-All.
19
The GOP doesn't have President Obama to kick around anymore. I am not sure that the millions that got health insurance voted, but maybe they will now...that will be, how can I say, terrific.
This dishonest stealth poisoning must not 'gaslight' the American people. Like watching a person choke without the decency to perform a Heimlich, the GOP thinks they can pretend they aren't responsible for both the needless death of insurance coverage for millions, but actual needless pain, suffering & death of people.
While ERs are mandated to provide free care to the uninsured, the remains patients with insurance will face long delays and cost shifting- a stealth 'tax' with huge waste and maximum cost.
While ERs are mandated to provide free care to the uninsured, the remains patients with insurance will face long delays and cost shifting- a stealth 'tax' with huge waste and maximum cost.
3
It's the outright lies about healthcare from this administration and republicans that's so disheartening and (until recently), so unamerican.
This article helps explain the degree not only of partisan divide but how far one group will go to keep its political fortunes alive.
History will remember this American scandal.
This article helps explain the degree not only of partisan divide but how far one group will go to keep its political fortunes alive.
History will remember this American scandal.
5
It is interesting (possibly only me) that evil lurks in the heart of these efforts doubtlessly inspired by a general hatred for poor people. Obviously, Christianity (in a biblical sense) accepts the poor and disenfranchised as normal/expected. In a GOP political sense, it is entirely unacceptable to be needy/poor. My greater curiosity is the antithetical expectation of the GOP that this pool of poor voters are controlled by propaganda to vote GOP. Sheer madness?
2
trump consistently and continually lets the American people down--he is extremely adept at propaganda--great lessons learned from putin. trump is not a Republican. Masked as an American who loves his country and its people, trump is a deconstructionist aimed at destroying American democracy by instilling chaos, hatred and fear among us, and the Republicans, to whom trump shows no loyalty, continue to enable him.
1
So what do Republicans get out of this? Is it only tax cuts for their donors? The most frightening point to me is that they don't even see the cruelty toward their own constituents, many of which seem to be fine with their own impending bankruptcy or even terrible death.
11
I think many Republican politicians and voters honestly believe that when things come for "free" from the government, that it undermines people's ability to take initiative and improve their own lives. And that, in turn, ruins America. They really believe that. And I am sure that there are instances of government "freebies" causing some people to work less (perhaps many of those people women who might choose to stay home with kids or care for elders if their healthcare were to be given by the gov't). But I am equally sure that that cost of freeloaders and deadbeats on the system is far outweighed by the benefits of things like Medicaid, Medicare and SS. But then, I am not a Republican.
What have we ever done to the GOP? We elected them, we keep them employed.
Why do they want us sick, unemployable, and dead?
I get the the whole small government ideology. But then, come up with a small government solution that *works.* That gets real care for people who cannot afford insulin, or a filling, or antibiotics, epi-pens and inhalers or heart medications.
In seven years, there has been no small government advancement. That's because anything they decide on will upset a large donor group, or undo employer based groups, or undo Medicare. They can only pick on the Medicaid and the uninsured who have no Citizens United funded group to speak for them.
Se we unravel and unravel, and have a government that is cheering for ill health, misery and death for millions of people, just so they can claim to have been right.
Of the People, by the people and for the people. With liberty and justice for all. But no healthcare.
Why do they want us sick, unemployable, and dead?
I get the the whole small government ideology. But then, come up with a small government solution that *works.* That gets real care for people who cannot afford insulin, or a filling, or antibiotics, epi-pens and inhalers or heart medications.
In seven years, there has been no small government advancement. That's because anything they decide on will upset a large donor group, or undo employer based groups, or undo Medicare. They can only pick on the Medicaid and the uninsured who have no Citizens United funded group to speak for them.
Se we unravel and unravel, and have a government that is cheering for ill health, misery and death for millions of people, just so they can claim to have been right.
Of the People, by the people and for the people. With liberty and justice for all. But no healthcare.
6
Why do they want us sick, unemployable, and dead?
Because they don't need us anymore. They don't need our labor, because they can use robots, or much cheaper workers abroad, and they don't really need our buying power, because they can now sell to a global market. We're no longer needed, so it's time for us to be terminated.
Because they don't need us anymore. They don't need our labor, because they can use robots, or much cheaper workers abroad, and they don't really need our buying power, because they can now sell to a global market. We're no longer needed, so it's time for us to be terminated.
1
The political cleavage between people who want to live by tribal law, and those who want societal law to remain supreme is still the dominant force in American life. The 'skinny repeal' fantasy is that tribal law can be empowered to determine any given individual's civil right to basic healthcare. It is predicated on the false idea that doing so does not result in all individuals' falling subject to tribal law.
It's actually the hard-kill option. The soft-kill option got voted-down yesterday. Maybe the seven senators and democrats who could have passed it will have a rethink after reading this excellent summary of the midair crash-and-burn option currently in progress.
Soft-kill is better. A controlled explosion of the Obamacare time bomb by the Senate bomb squad, clearing the decks for a fresh discussion. It's not such a big deal, just turning the clock back to 2008. Just do it. Bah.
Soft-kill is better. A controlled explosion of the Obamacare time bomb by the Senate bomb squad, clearing the decks for a fresh discussion. It's not such a big deal, just turning the clock back to 2008. Just do it. Bah.
1
Could it be that the GOP treatment of Obamacare and the plan(s) they propose will be the last hurra of the party for a generation? Republican thinking is fifty yers out of date with World trends. As the hardcore Republcan voters go reealizing what is happening, the will switch to something else. Is that good or bad? We need an up to date party to balance the balance that is basic to democracy
Tom Price, another incompetent, courtesy of Trump. Does he even understand how insurance works.
The words “First, do no harm” mean as little to Price as does "will to the best of my Ability, preserve, protect and defend the Constitution of the United States."
Is it illegal to deliberately under-fund established law in order to cause it to fail? Can the ACLU or CREW sue? Lawsuits are the only thing Trump seems to understand.
The words “First, do no harm” mean as little to Price as does "will to the best of my Ability, preserve, protect and defend the Constitution of the United States."
Is it illegal to deliberately under-fund established law in order to cause it to fail? Can the ACLU or CREW sue? Lawsuits are the only thing Trump seems to understand.
1
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.
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.
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
2
Very well said, and a timely article set forth in logical manner.
Absolutely the Trump Administration set out with a goal to undermine the Affordable Care Act specifically since it was an Obama signature achievement.
Trump issued an Executive Order, then stopped advertising the enrollment deadline. 1. Discouraged enrollment. 2. Created great uncertainty.
3. Meanwhile, Republicans spoke of another healthcare plan, as Trump threatened to top funding the Affordable Care Act.
4. Threatened payments to insurers, and again fostered a sense of calamity and uncertainty. 5. Failed to include Obama's critical; cost-sharing provision in the budget, which undermined insurers so they would raise premiums.
6. The administration's disinformation campaign to discredit Obamacare was intensified. 7. They released damaging videos, while scrubbing the website.
8. Seven days ago they scrapped Obamacare signups in 18 cities.
9. This makes it more difficult to people to sign up. 10. There's confusion, less time to enroll this year. 11. Community advocates are rushing to help people enroll, compare and shop Obamacare---since Trump is hurting enrollment on purpose.
Donald Trump is saying Obamacare is failed, when he is the one who has continued to sabotage it.
https://www.cbpp.org/sabotage-watch-tracking-efforts-to-undermine-the-aca
Absolutely the Trump Administration set out with a goal to undermine the Affordable Care Act specifically since it was an Obama signature achievement.
Trump issued an Executive Order, then stopped advertising the enrollment deadline. 1. Discouraged enrollment. 2. Created great uncertainty.
3. Meanwhile, Republicans spoke of another healthcare plan, as Trump threatened to top funding the Affordable Care Act.
4. Threatened payments to insurers, and again fostered a sense of calamity and uncertainty. 5. Failed to include Obama's critical; cost-sharing provision in the budget, which undermined insurers so they would raise premiums.
6. The administration's disinformation campaign to discredit Obamacare was intensified. 7. They released damaging videos, while scrubbing the website.
8. Seven days ago they scrapped Obamacare signups in 18 cities.
9. This makes it more difficult to people to sign up. 10. There's confusion, less time to enroll this year. 11. Community advocates are rushing to help people enroll, compare and shop Obamacare---since Trump is hurting enrollment on purpose.
Donald Trump is saying Obamacare is failed, when he is the one who has continued to sabotage it.
https://www.cbpp.org/sabotage-watch-tracking-efforts-to-undermine-the-aca
6
Chin up. We may be heading for our Churchill moment, when America does the right thing after trying everything else. The people want universal healthcare coverage because it creates universal peace of mind. The rest of the developed world has proven that it's affordable. Now, we just have to convince ourselves that nothing else works as well.
I admire John McCain, but I have never been impressed by his political (as opposed to military) courage. (Sarah Palin? Really?) But now he has become Dr. Johnson's man who knows he is to be hanged in a fortnight, and it has concentrated his mind wonderfully. Churchill's witticism captures the same phenomenon, writ large. With the failure of the repeal effort, America will have tried everything else first. The time has come to do the right thing.
I admire John McCain, but I have never been impressed by his political (as opposed to military) courage. (Sarah Palin? Really?) But now he has become Dr. Johnson's man who knows he is to be hanged in a fortnight, and it has concentrated his mind wonderfully. Churchill's witticism captures the same phenomenon, writ large. With the failure of the repeal effort, America will have tried everything else first. The time has come to do the right thing.
1
It was already failing under Obama, Trump is just not saving it from jumping off a cliff. The bottom line, whether state funds or federal funds are used, is that we don't have the money for such a program. The argument that "the US is rich enough to give everyone healthcare" sounds fantastic, but it's not true.
I always thought the Dem idea of figuring out some end-of-life issues would have dramatically saved costs (so much of our healthcare costs are for the last year of someone's life) but they were called "death panels" by the Repubs.
I wished the math could work out where we could cover everyone, but that doesn't see to be the case.
I always thought the Dem idea of figuring out some end-of-life issues would have dramatically saved costs (so much of our healthcare costs are for the last year of someone's life) but they were called "death panels" by the Repubs.
I wished the math could work out where we could cover everyone, but that doesn't see to be the case.
1
According to your argument the US cannot afford to provide affordable care for its citizens. But we certainly can afford to be scampering all over the world with our military might. Do you realize that the Iraqui adventure cost almost 2 trillion?
Can you imagine instead of using those funds for armament how much good could be done medically for our population?
Can you imagine instead of using those funds for armament how much good could be done medically for our population?
15
CA tried this a couple of months ago....welfare healthcare for everyone. they ran out of other people's money before it could even get off the ground
That's definitely a fair point and we will have to prioritize healthcare over other things to get the math to ever work out. I am in favor of cutting the military budget, but we've seen how difficult that can be too (did you see how much blowback there was after trying to get rid of the A-10 program?).
The only real way to cut military spending is by tearing up or "revising" many of the treaties we are in. These treaties require us to spend, spend, spend in order to protect our allies.
The only real way to cut military spending is by tearing up or "revising" many of the treaties we are in. These treaties require us to spend, spend, spend in order to protect our allies.
1
The Obama administration kept insurance providers in the Affordable Care Act market by transferring money from the Treasury to cover their losses. But a federal court has ruled this transfer of funds is unconstitutional. District Court Judge Rosemary Collyer ruled that the Constitution says "No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.” She said “Paying [those] reimbursements without an appropriation thus violates the Constitution. Congress is the only source for such an appropriation, and no public money can be spent without one." Republicans asked for and were granted an abeyance to give them time to repeal and replace the ACA, but if their efforts prove unsuccessful, Judge Collyer’s ruling will go into effect, and the ACA market will collapse. Senators who oppose repeal and replace will be responsible for the turmoil that ensues.
Since it's quite evident that any replacement the GOP proposes would be greatly inferior to what's there now, the fault is with the Congress that refuses to make the appropriation that was clearly the intent of the original bill.
1
The constitution also says that only congress may declare wars. In the many wars we have been involved in since WW2, I don't recall congress ever declaring war.
Another case of the selective use of the constitution.
Another case of the selective use of the constitution.
3
The original intent was that Obamacare would pay for itself by forcing younger, healthier people to subsidize older, sicker people and people with preexisting conditions by buying health insurance policies they wouldn't otherwise buy. But the costs were much higher than projected and more younger people than expected paid the tax penalty rather than buy insurance.
"... whether any plan delivering quality health care at an affordable price could survive a relentless assault like this, remains an open question."
Another superb analysis of the situation by T. Edsall, but the last line of his column pays tentative homage to the audacity of hope. The column's theme, however, all but ensures the inevitability of disappointment.
Trump and his band of cutthroats have their scalpels at the ready but they should realize that when it comes to insurance markets, a slice and dice here and there leads to systemic changes throughout the marketplace. Columns like this one make it clear that the Republicans should be reaping the blame when insurance markets implode and hospitals -- a crucial element of the countries infrastructure -- start to fail.
However, what if insurance coverage is the wrong basket for government to lay all its public health eggs. Why not during this time of upheaval turn to proven public health strategies and use them to combine incentives for achieving a healthy lifestyle with disincentives for falling short of the mark?
Smoking has decreased significantly and cessation clinics plus advertising have helped. Why not do the same for weight reduction? Thanks to our persistent mortality, some health crises are totally unavoidable, but others, like type 2 diabetes, can have less of an impact with healthy life style changes.
Insurance does not = good health and does not always = good healthcare.
We need a better plan.
Another superb analysis of the situation by T. Edsall, but the last line of his column pays tentative homage to the audacity of hope. The column's theme, however, all but ensures the inevitability of disappointment.
Trump and his band of cutthroats have their scalpels at the ready but they should realize that when it comes to insurance markets, a slice and dice here and there leads to systemic changes throughout the marketplace. Columns like this one make it clear that the Republicans should be reaping the blame when insurance markets implode and hospitals -- a crucial element of the countries infrastructure -- start to fail.
However, what if insurance coverage is the wrong basket for government to lay all its public health eggs. Why not during this time of upheaval turn to proven public health strategies and use them to combine incentives for achieving a healthy lifestyle with disincentives for falling short of the mark?
Smoking has decreased significantly and cessation clinics plus advertising have helped. Why not do the same for weight reduction? Thanks to our persistent mortality, some health crises are totally unavoidable, but others, like type 2 diabetes, can have less of an impact with healthy life style changes.
Insurance does not = good health and does not always = good healthcare.
We need a better plan.
2
A recent Times article after the last failed ACA vote cited 'the Republicans' had decided to concentrate instead on tax issues - spearheaded of course by the Koch brothers.
The Koch coalition spends huge amounts of money for legal bribes to politicians and to support it's tax fee think tanks to put more money into their pockets. They use the media outlets they own to support their propaganda efforts.
The fight against the ACA is all about taking every slice they can from the government pie and eating it themselves.
The Koch coalition spends huge amounts of money for legal bribes to politicians and to support it's tax fee think tanks to put more money into their pockets. They use the media outlets they own to support their propaganda efforts.
The fight against the ACA is all about taking every slice they can from the government pie and eating it themselves.
3
The Republican fall-back solution to those unable to purchase a plan?
"Go to the emergency room." To those not vagrants or transients, the bill's in the mail.
"Go to the emergency room." To those not vagrants or transients, the bill's in the mail.
2
When will I wake up from this nightmare? The GOP is the party of evil and it will always be. Vote them out!!
Trump is a crybaby in diapers.
Trump is a crybaby in diapers.
13
The nightmare will go on until there is a political party that can mount a credible argument against what the Republicans are doing. That will not be the pathetic Democratic Party.
Why is the American Hospital Association so quiet ?
Going forward, with so many "choosing " not to have health Insurance the ER's will be swamped by people who cannot pay for their care. I blame Cable TV also for being in the beltway bubble and not going around the country talking to real people and rural hospitals . There should have been TV cameras at the RAM in Virginia with Nick Kristoff.
Going forward, with so many "choosing " not to have health Insurance the ER's will be swamped by people who cannot pay for their care. I blame Cable TV also for being in the beltway bubble and not going around the country talking to real people and rural hospitals . There should have been TV cameras at the RAM in Virginia with Nick Kristoff.
15
The republican party and its supporters are exactly what they appear to be.
The only important matter is whether or not the American people will countenance the actions of the republicans in their effort to, as surreptitiously as possible, subvert the healthcare of millions.
If those same people who voted for Donald Trump, Ted Cruz, Mitch McConnell, Paul Ryan, Sam Brownback, Mike Pence, et al believe that such actions are valid, then the rule of law in this country has a short runway ahead of it. Toss in the small matter of potential sedition by this administration's increasingly likely collusion with Russia to disrupt the election of our president, well then, those republicans will have a lot to answer for in future history books.
George Orwell was directionally right with his view of the future; he just missed the timing. Instead of "1984," he may have missed the changes by some decades or a century.
The only important matter is whether or not the American people will countenance the actions of the republicans in their effort to, as surreptitiously as possible, subvert the healthcare of millions.
If those same people who voted for Donald Trump, Ted Cruz, Mitch McConnell, Paul Ryan, Sam Brownback, Mike Pence, et al believe that such actions are valid, then the rule of law in this country has a short runway ahead of it. Toss in the small matter of potential sedition by this administration's increasingly likely collusion with Russia to disrupt the election of our president, well then, those republicans will have a lot to answer for in future history books.
George Orwell was directionally right with his view of the future; he just missed the timing. Instead of "1984," he may have missed the changes by some decades or a century.
25
Healthcare in the U.S.? Prospects for universal healthcare?
A poll should be taken asking Americans which they feel would be more difficult to understand/which would be the easiest course to pursue in the educational system: Actually going into medicine, becoming a doctor or nurse or going into research, or trying to make sense of how healthcare operates and how it can and cannot operate (parameters of operation with respect to average citizen). I suspect overwhelmingly people would feel it would be much easier and much more clear to grind away at medical textbooks, learn the terminology, and actually to become a doctor than to go through the hash of political/economic squabbling about how to get the system of healthcare to operate more efficiently, not least because ironically, for all medical advance, all attempt to actually prevent and cure people from illness and harm the healthcare system seems in many respects to want to do the opposite, which is to say is an anti-medicine response by society to medicine.
I would say it's bizarre, but this parallels many developments in human society: Technological advance (weapons, communications) belongs to ME, not YOU. Increase of wealth benefits ME, not YOU. Land belongs to ME, not YOU. Health belongs to ME, not YOU. Health essentially in modern society is an important part of political/economic, international/military jousting. YOUR health must be better than THEIRS or they are likely to defeat you in battle, life. Breathe!
A poll should be taken asking Americans which they feel would be more difficult to understand/which would be the easiest course to pursue in the educational system: Actually going into medicine, becoming a doctor or nurse or going into research, or trying to make sense of how healthcare operates and how it can and cannot operate (parameters of operation with respect to average citizen). I suspect overwhelmingly people would feel it would be much easier and much more clear to grind away at medical textbooks, learn the terminology, and actually to become a doctor than to go through the hash of political/economic squabbling about how to get the system of healthcare to operate more efficiently, not least because ironically, for all medical advance, all attempt to actually prevent and cure people from illness and harm the healthcare system seems in many respects to want to do the opposite, which is to say is an anti-medicine response by society to medicine.
I would say it's bizarre, but this parallels many developments in human society: Technological advance (weapons, communications) belongs to ME, not YOU. Increase of wealth benefits ME, not YOU. Land belongs to ME, not YOU. Health belongs to ME, not YOU. Health essentially in modern society is an important part of political/economic, international/military jousting. YOUR health must be better than THEIRS or they are likely to defeat you in battle, life. Breathe!
8
This is a wonderful column. But it raises a fundamental question: Why is the Democratic party so incapable of presenting the ACA so that the public understands the facts? For years, relentless Republican propaganda has told people that the ACA is bad policy, while for years Democrats have done little to explain why it is good. I'll wager that most people didn't even realize that the ACA protected them from preexisting conditions exclusions until after Trump was elected; they simply took this benefit for granted. That was failed marketing on the Obama administration's part.
Even now, Democrats are opposing the Republicans' alternatives by arguing that Republican policy will give the wealthy unneeded tax breaks. Why aren't they arguing for the ACA's strengths and benefits instead? Once again, the Democratic party and democracy itself are in danger of being defeated by right-wing propaganda and misinformation. Democrats may finally be mounting a credible defense, but they need to master an undefeatable offense as well. If the ACA is destroyed, it will not be only the Republicans' fault.
Even now, Democrats are opposing the Republicans' alternatives by arguing that Republican policy will give the wealthy unneeded tax breaks. Why aren't they arguing for the ACA's strengths and benefits instead? Once again, the Democratic party and democracy itself are in danger of being defeated by right-wing propaganda and misinformation. Democrats may finally be mounting a credible defense, but they need to master an undefeatable offense as well. If the ACA is destroyed, it will not be only the Republicans' fault.
73
Read the article's descriptions of the myriad subtle ways the Republicans are undermining care while blaming Democrats.
Don't blame the Democrats if the Republicans' simple- minded slogans and outright lies easily win out over the Democrats' reasoned and substantive arguments and hard and thoughtful work to create an effective system while being constantly undermined by Republicans.
Don't blame the Democrats if the Republicans' simple- minded slogans and outright lies easily win out over the Democrats' reasoned and substantive arguments and hard and thoughtful work to create an effective system while being constantly undermined by Republicans.
17
The Democrats lost their best wordsmiths like Molly Ivins and Ann Richards. Instead we have Perez and Schumer and Hillary. Bill Clinton was great in his hey day but age has robbed him and us of his clear and concise way of speaking.
1
Obamacare is a massive wealth redistribution scheme that meddles with 1/6th of the economy.
The reality of any such bill is complex.
Yes, there are winners. But there are also losers. Who are the Obamacare losers? They include the young and healthy, most of the self-employed, most of those who work for small businesses, those who lost the freedom to choose the insurance they would prefer, those who lost the freedom to self insure, those who pay the $1T of Obamacare taxes, those who have employer sponsored insurance who had to pay the Obamacare tax/fee on such plans, independent physicians and smaller healthcare providers in general.
You cannot seriously expect that the many people adversely affected by Obamacare, the Obamacare losers if you will, will suddenly change their minds about Obamacare if they only knew the benefits that the winners under the scheme that the Obamacare winners were getting. In fact, it might only annoy them more.
We should not pretend there are no people who are worse off with Obamacare. There are, in fact, many.
The reality of any such bill is complex.
Yes, there are winners. But there are also losers. Who are the Obamacare losers? They include the young and healthy, most of the self-employed, most of those who work for small businesses, those who lost the freedom to choose the insurance they would prefer, those who lost the freedom to self insure, those who pay the $1T of Obamacare taxes, those who have employer sponsored insurance who had to pay the Obamacare tax/fee on such plans, independent physicians and smaller healthcare providers in general.
You cannot seriously expect that the many people adversely affected by Obamacare, the Obamacare losers if you will, will suddenly change their minds about Obamacare if they only knew the benefits that the winners under the scheme that the Obamacare winners were getting. In fact, it might only annoy them more.
We should not pretend there are no people who are worse off with Obamacare. There are, in fact, many.
1
Here's a modest proposal the Republicans should embrace as they attempt to remove the individual mandate from the ACA. Since their concept is the people should have freedom of choice not to participate in the insurance pool, that should also extend to government mandated free care. In this approach people would have an option to participate in the current system or, alternatively, to receive a Medical Freedom Card. Hospitals would the be permitted to refuse or withdraw emergency life sustaining care if the card holders were unable to pay. It's a win-win since it frees hospitals from an unfunded big government mandate and saves freedom loving individuals from the humiliation of mooching at public expense.
18
I suggest a slight modification. Simply reform bankruptcy laws to make medical debt non-dischargeable. So, if you choose to not purchase insurance, but rather to self-insure your own healthcare AND you find yourself in need of healthcare you cannot pay for, you could either A) do without or B) consume the healthcare, but be required to pay for it even if it takes decades to pay.
I suspect a secondary market would arise to deal with the financing of such debt.
In other words, if you choose to self insure and need healthcare you cannot afford, we, your fellow citizens, won't make you die in the street, but we DO expect you to pay your own way. This is the essence of taking responsibility for your actions.
I suspect a secondary market would arise to deal with the financing of such debt.
In other words, if you choose to self insure and need healthcare you cannot afford, we, your fellow citizens, won't make you die in the street, but we DO expect you to pay your own way. This is the essence of taking responsibility for your actions.
1
I've often had the same thought but called the card the "Do Not Treat" card. Treatment would be offered only with upfront payment or lien on assets, etc.
1
With all due respect, what would assist is for folks supporting the ACA to stop referring to it as "Obamacare". This term is intended to be pejorative and derogatory, as it comes from those opposed to Obama and government assisted health care.
The use of the term "Obamacare" allows the impression that the action is against Obama, not against affordable care for the public.
Please do not assist the GOP and those against the act. It as the "Affordable Care Act", or the ACA.
The use of the term "Obamacare" allows the impression that the action is against Obama, not against affordable care for the public.
Please do not assist the GOP and those against the act. It as the "Affordable Care Act", or the ACA.
58
I like using the term because it gives credit to the initiator of a health plan for everyone in this country. It may not be the best plan, but it was what he could get. That's infinitely more than was proposed or provided by any R's - EVER.
They can't stand it not only because he's a Democrat, but a black one at that. Actually I think the R's inherent racism makes his party affiliation a minor issue.
So I will keep using it, not in a pejorative but a celebratory way.
They can't stand it not only because he's a Democrat, but a black one at that. Actually I think the R's inherent racism makes his party affiliation a minor issue.
So I will keep using it, not in a pejorative but a celebratory way.
3
If the Republican Party had spent the past seven years attempting to improve the Affordable Care Act, perhaps we, as a nation, could have moved on to the next (there's always a "next") insoluble problem. But no; the GOP is eating our young (and old) with their relentless assault on national health care. This is the latest chapter in Newt Gingrich's Contract With America which grew out of Ronald Reagan's "government is the problem."
Obamacare evolved from a quintessentially right-wing thought process. The (black) president examined the moving parts, especially those he found to work under Mitt Romney (R-Mass), and thought it might work on a national basis. There was, as I recall, no Republican opposition to Gov. Romney's administration of state-sponsored care. It only became a national scandal after President Obama took it up and presented it to the nation.
Let's be clear; political opposition to the ACA has nothing at all to do with finances or choices. Tom Price, Paul Ryan and Mitch McConnell are all invested in destroying the black president's law. Their own president, otherwise disinterested and indifferent to complexities, was in lockstep with McConnell's "one-term president" bugle call long before 2016. They're all flying the Stars and Bars; theirs is an updated version of the Civil War, a secession from reality. That "The Other" tinkered with it, and made it workable, makes it that much more exasperating.
Many millions who once loathed it have come to need it.
Obamacare evolved from a quintessentially right-wing thought process. The (black) president examined the moving parts, especially those he found to work under Mitt Romney (R-Mass), and thought it might work on a national basis. There was, as I recall, no Republican opposition to Gov. Romney's administration of state-sponsored care. It only became a national scandal after President Obama took it up and presented it to the nation.
Let's be clear; political opposition to the ACA has nothing at all to do with finances or choices. Tom Price, Paul Ryan and Mitch McConnell are all invested in destroying the black president's law. Their own president, otherwise disinterested and indifferent to complexities, was in lockstep with McConnell's "one-term president" bugle call long before 2016. They're all flying the Stars and Bars; theirs is an updated version of the Civil War, a secession from reality. That "The Other" tinkered with it, and made it workable, makes it that much more exasperating.
Many millions who once loathed it have come to need it.
99
The black president and liberal democrats spent eight years trying to destroy America!
President Trump truly cares about the heart ❤️ and soul of America!
America First!
President Trump truly cares about the heart ❤️ and soul of America!
America First!
The most important part of this is the quote from Bill Kristol: the Republicans can't afford to let the government do anything good because then people will like it.
Wow.
And people vote for a party that thinks like that?
Wow.
And people vote for a party that thinks like that?
184
@green tea:
This is what 50 years of demonizing government has rendered.
This is what 50 years of demonizing government has rendered.
1
I know I am repeating myself but "We need bipartisanship on this important issue and not constant attacks on Trump and Republicans by the New York Times which will only continue the battle and without a ceasefire."
Give up the pleasure of attacking Republicans and exchange it for a bipartisan plan which covers ALL Americans!
And oh, I drink BOTH green tea AND coffee. I recommend this form of bipartisanship to you! (smile).
Give up the pleasure of attacking Republicans and exchange it for a bipartisan plan which covers ALL Americans!
And oh, I drink BOTH green tea AND coffee. I recommend this form of bipartisanship to you! (smile).
Green tea--
It is amazing. Ted Cruz had made a similar comment a few years ago, something about it being sugar for the masses..
It is amazing. Ted Cruz had made a similar comment a few years ago, something about it being sugar for the masses..
As pointed out in this article the Republican Party has rebuilt itself on the back of "Obamacare", demanding that it be repealed; that it is unconstitutional; that it will bring great harm to Americans. All of these claims and more since its inception in 2010. The Republicans cannot not do anything at this point. Their entire take over of most state and our federal government is based on this one simple core: repeal Obamacare.
That the premise is wrong and that many, many more Americans have been helped by the A.C.A. than harmed by it has never been acknowledged by the party. It never will be. But now Americans and the party must understand that if the law is repeals from 22 to 40 millions Americans will lose access to our healthcare system either by losing Medicaid, or by losing their healthcare insurance. That is a fact.
I think the Republicans will blunder on and do their best to kill the A.C.A. They have no choice if they want to continue as a political force. They have put their political survival above the survival of millions of Americans. That is their legacy. I am glad it is not mine.
That the premise is wrong and that many, many more Americans have been helped by the A.C.A. than harmed by it has never been acknowledged by the party. It never will be. But now Americans and the party must understand that if the law is repeals from 22 to 40 millions Americans will lose access to our healthcare system either by losing Medicaid, or by losing their healthcare insurance. That is a fact.
I think the Republicans will blunder on and do their best to kill the A.C.A. They have no choice if they want to continue as a political force. They have put their political survival above the survival of millions of Americans. That is their legacy. I am glad it is not mine.
47
Mr. Edsall, what a fantastic summary of Republican sabotage efforts. This helps remind people that we have one party working to build America and one trying to tear it down.
It's more than a little ironic that back the 1980's and 1990's, the outlines of Obamacare were drawn by conservatives at the Heritage Foundation, which included an individual mandate (to prevent "free riders"), subsidies for the poor, and Medicaid reform.
With the more liberal public option and single payer options out of reach, Democrats enacted that conservative plan to solve problems, crossing the aisle conceptually despite Republicans refusing to cooperate even to pass their own policy. Over 20 million people got affordable insurance. This is a memorable lesson in just how radicalized the GOP has become.
Democrats have proven they can govern, with better GDP growth, job creation, and stock market returns under Democratic Presidents since World War II. When the crisis of banking deregulation and trickle-down hit in 2008, it was Democrats to the rescue, with stimulus, Obamacare, and Dodd-Frank, all over Republican opposition.
Our country now has record household net worth ($750,000 per family on average), although we continue to have an inequality problem (the bottom 50% of families average $11,000 net worth). Obamacare pushed back against this inequality, with higher taxes on the rich used to fund subsidies.
It's important the Democrats keep these facts front and center.
It's more than a little ironic that back the 1980's and 1990's, the outlines of Obamacare were drawn by conservatives at the Heritage Foundation, which included an individual mandate (to prevent "free riders"), subsidies for the poor, and Medicaid reform.
With the more liberal public option and single payer options out of reach, Democrats enacted that conservative plan to solve problems, crossing the aisle conceptually despite Republicans refusing to cooperate even to pass their own policy. Over 20 million people got affordable insurance. This is a memorable lesson in just how radicalized the GOP has become.
Democrats have proven they can govern, with better GDP growth, job creation, and stock market returns under Democratic Presidents since World War II. When the crisis of banking deregulation and trickle-down hit in 2008, it was Democrats to the rescue, with stimulus, Obamacare, and Dodd-Frank, all over Republican opposition.
Our country now has record household net worth ($750,000 per family on average), although we continue to have an inequality problem (the bottom 50% of families average $11,000 net worth). Obamacare pushed back against this inequality, with higher taxes on the rich used to fund subsidies.
It's important the Democrats keep these facts front and center.
105
But the poor don't vote and certainly don't make campaign contributions.
2
They will be undermining Medicare next.
124
They already are.
2
And then they'll come for Social Security.
This is a partisan apology for a plan that was flawed from the beginning and was failing long before Trump was elected. Insurance can't possibly work when insurance companies are required to provide it, but healthy people aren't required to pay for it.
21
Are you referring to the ACA? Have you heard of the individual mandate?
3
Two thoughts:
Obamacare mandated that healthy people buy insurance; it was the Republicans who claimed this denied us our freedom. So your point gives credence to this whole article's point -- that Republicans are dismantling the ACA by strangling it.
Second, just because you're healthy doesn't mean you're wealthy! And you can be working full-time (plus) and still be unable to afford insurance.
I'll take the flawed ACA over the vaporware the Republicans are selling -- what is their plan?
Obamacare mandated that healthy people buy insurance; it was the Republicans who claimed this denied us our freedom. So your point gives credence to this whole article's point -- that Republicans are dismantling the ACA by strangling it.
Second, just because you're healthy doesn't mean you're wealthy! And you can be working full-time (plus) and still be unable to afford insurance.
I'll take the flawed ACA over the vaporware the Republicans are selling -- what is their plan?
Len, you can pay the penalty then buy insurance when you need it. Make the penalty the same as the most expensive plan in the nation, then ACA could work.