Let's hope the politicians stop playing partisan games now and start working to improve ACA... Probably won't happen, but I can dream.
CNN ACA Repeal Effort Fails
The skinny bill would have been foolish, since it would have:
CNN ACA Repeal Effort Fails
The skinny bill would have been foolish, since it would have:
- Removed the mandates
- Removed funding sources
- And not cut the expenses significantly
69 comments:
Partisan or not, the Republican plan to take health care insurance away from 22 million Americans in order to fund tax cuts for the rich just isn't one we feel a lot of pressure to sign on to. What's amazing to me is the argument that Republicans were reduced to last night, in effect, it's ok to vote for this bill because it will never pass, isn't that it had no appeal for Democrats, rather that it had so much appeal for so many Republicans.
--Hiram
The 2017 healthcare debate has only featured partisan games from one side of the aisle. Let's hope their fever has broken and they are now ready to embrace reasonable fixes to the ACA.
Sorry Guys... But the DEMs have been just as childish as the GOPers...
All they talk about those folks who will "lose insurance", none of them are concerned about all of us who are paying more so those folks can have their free and reduced cost insurance.
And no talk about how to strongly encourage the people who are getting this welfare health insurance to adopt healthier lifestyles and only have the children they can afford themselves on their incomes.
Now you can keep ignoring the terrible choices and consequences that welfare programs encourage, but it is going to damage our country sooner or later.
"none of them are concerned about all of us who are paying more so those folks can have their free and reduced cost insurance."
That's not true at all. We want everyone -- even "those folks" -- to have the same guarantees should they hit hard times.
Did you forget that most medicaid spending goes to the elderly, disabled, and children?
Did you forget that people who receive Obamacare subsidies have jobs?
While the dems are clearly not childish nor equally partisan as the GOP, it wold be smart to include ways to contain costs in healthcare spending moving forward. While dems were trying to save access to healthcare for 10-30 million people was the wrong time for those talking points.
Btw, Obamacare did include ideas for reducing the rate of increase in healthcare spending. More needs to be done but it is very tricky because people want unlimited access at no or low cost to all healthcare procedures. I think govt should provide insurance which I will label basic and the rich can buy supplemental insurance however inclusive and expensive as they want.
Conceptually, the problem Obamacare has always presented for Republicans is that it is too close to Republican policy, and they so they find it literally impossible to oppose while also providing an alternative. In the final analysis, it is just impossible to both have and eat the cake.
In practical political terms, Republicans wanted to take money away from health care in order to fund tax cuts for the wealthy. That just isn't a very popular idea to bring before the American people. What you can do is confuse the issue. Bring in distracting issues, like the adopting healthier life styles among poor people thing. But as we have just seen, I guess, ultimately that doesn't work.
--Hiram
This is what you get when you elect Republicans
Laurie,
Georgetown Medicaid
Participation:
Elderly 8%
Disabled 15%
Adults 27%
Children 50%
Spend:
Elderly 20%
Disabled 44%
Adults 14%
Children 22%
That means that 77% of people on Medicaid are able bodied Adults and/or the children of Adults who had children they could not afford to care for themselves !!!
How do we turn this around?
36% of this spend is in essence welfare for the foolish and irresponsible.
More employers could offer health insurance as a benefit.
Laurie,
As I often say... This is not about health insurance...
This is about compensation which can be provided in many forms...
Be it healthcare benefits, a larger pay check, bonuses, etc...
And if you truly want to raise the compensation in America and the disposable household incomes...
Buy domestic, deport illegal workers, push people to get more skills / academics, push people to get/stay married before having children, push people to relocate to where the jobs are, etc.
"This is what you get when you elect Republicans"? Well, Obamacare is what you get when you elect too many Democrats. And if we had elected ENOUGH Republicans we could have undone this disaster and done something better. As for those poor 22 million that would "become uninsured" I have a bit of news on that. The CBO assumes that nobody would buy insurance if the individual mandate were lifted. And yet millions of people are already uninsured and forced to pay a "penalty" for staying that way. It's ridiculous to try to force people to buy something they don't want, don't need, can't afford and can't use.
CBO forecasts are like coins that have two sides. Republicans like to attack the projections that say 22 million Americans would lose their health insurance. But the whole point of Trump Care is to insure less so the savings can be used to fund the tax cuts they want, as forecasted by those CBO projections. Is it really possible to throw out one side of the coin while keeping and spending the other?
Lots of people don't want health insurance. They know that they can get care for free.
--Hiram
Jerry,
As I told Laurie... This is a money discussion...
See page 20 of the analysis. Without the medicaid expansion and subsidies people will simply take on more risk instead of paying a large portion of their household income into paying for insurance.
CBO ACHA Analysis
And the reality is that the current fine for not carrying health insurance is way too small to force people to comply. It really needs to be raised to get everyone paying into the pool that they may need to access later.
MP GOP Unlikely to Stop Trying
Who takes on the risk when people decide not have health insurance? People like taxpayers, and health care providers.
The point is frequently argued here that health insurance isn't the same thing as health care. I generally don't know why that distinction matters but here is an instance where it does. Health insurance doesn't protect one's health. Insurance agents can't prescribe drugs and they don't perform surgery. What it does do is protect one's wealth. And if someone doesn't have any money, there isn't a lot of reason to insure against the losing of it.
--Hiram
That is why I agree with the mandate...
As a society we have agreed that everyone will receive medical care if needed.
It is so odd that Conservatives want to let people free ride by not carrying insurance and paying into the pool when they say they are against free loading.
Of course Medicaid and the subsidies complicate things since they are freebies to many at the expense of the tax payers.
So what ACA should have done is to make hidden expenses visible by reducing the number of:
- bankruptcies
- uncollected debt
- uncompensated care
- etc
CR Medical Bankruptcies Down
Health care policy is so difficult because so many people ask it to do so many different and sometimes contradictory things.
Elsewhere, I have compared the politics surrounding health care to fighting a war in hedge row country. What too easily happens is that we fight one small battle after another going on to infinity, in each case with a well armed, well financed opponent who, just between you and me, isn't always totally wrong. The immense difficult bordering on the near impossibility of that is part of the reason why it's so difficult for any health care policy initiative to succeed. The Republican failure to either replace or repeal Obamacare last week is only the most recent example of that.
--Hiram
CNN Susan Collins Proposal
"And the reality is that the current fine for not carrying health insurance is way too small to force people to comply. "
FORCE people to comply? You mean "you must buy what we tell you to buy, whether you need it or want it, and if you refuse to buy it, or can't afford to buy it, we will take money away from you for the privilege of not buying it." Who put the monkeys in charge of the zoo?
Outrageous! I get a constituent letter from Al Franken today, echoing what many Democrats have been saying, that they now want a "bipartisan" approach to fixing health care! Where was bipartisanship when this kludge was created, with Al Franken as the 60th all-Democrat vote to ram it down our throats? Where was this bipartisanship when the Republicans offered up bills for debate, and every Democrat voted against even debating and amending? Had just one of 48 Senate Democrats voted to make this a bipartisan bill, we could be starting the process of fixing this massive mishmash of broken promises. Shameful!
"Where was bipartisanship when this kludge was created,"
You know the answer, yet you continue to obfuscate. Democrats can't hold a candle to the obstruction of the legislative process that the Republicans have been foisting upon us.
Please stop lying.
Moose
Jerry,
We need mandatory health insurance just like we require mandatory disability / old age insurance(ie medicare / SS) otherwise irresponsible free loaders don't save enough or buy it to cover their healthcare costs.
And we all end up paying more because of their irresponsible choices / actions.
I am fine with letting people opt out if they can prove that they are self insured. Maybe $2 million net worth and that they are willing to forfeit it if they incur a long term chronic condition.
Moose, Obamacare only became law because it passed the House with ZERO Republican votes, and passed the Senate ONLY because Al Franken was very briefly the 60th Democrat vote. The Republicans couldn't "obstruct" anything, but the Democrats are certainly obstructing the "fix" to it.
We do NOT need mandatory health insurance, any more than we need mandatory grocery insurance. And I still do not understand why somebody's irresponsibility with their own health care costs suddenly makes those costs MY responsibility? It's just weird, and encourages exactly the kind of freeloading you decry. I will say one nice thing about Hillarycare, believe it or not. That is, if you went to the clinic or hospital and did not have the insurance, you were signed up automatically and had to pay for it (with subsidies available as I recall).
If as a society we want to agree that having health CARE available for people is an investment in a productive citizen AND, perhaps, a moral obligation (though should government be forcing its morality on us?), then there are a lot of ways to do that but giving people insurance, or forcing them to buy it, does not accomplish that. Public health clinics, or tax credits for providers to the indigent, or even a far more competitive health care/insurance sector could do that far better. We just need to give up the notion that our "betters" in Washington know better than the rest of us.
I think the Conservatives are losing this argument...
"Obamacare only became law because it passed the House with ZERO Republican votes, and passed the Senate ONLY because Al Franken was very briefly the 60th Democrat vote."
So? Parties that have the majority get to attempt to enact their agenda. However, you are lying when you suggest that Republicans had no say. Anyone who knows what actually happened and is interested in the truth instead of an agenda shouldn't be continuing with this baseless argument that Republicans had no input. It's disingenuous at best and makes you look like the ignorant partisan you apparently are.
The Republicans are trying to pass health care bills in secrecy and under the cover of night. The Democrats did everything in the broad light of day with Republicans there every step of the way. It can be rightfully argued that the Democrats capitulated too much to the Republicans, which is why the ACA has some of the problems it does. Republicans continue to prove that they have no idea how to govern.
Moose
How many Republican amendments to the Obamacare bill were allowed during the debate on the legislation? history lesson
And I would argue that, aside from the tactics and the actual contents of the two bills, there is a substantive and highly partisan difference in the public statements surrounding each. The ACA was sold as increasing competition, lowering costs, insuring everybody, and "if you like your plan you can keep your plan." None of that, said by Democrats, was true. The AHCA is being painted as "millions of Medicaid recipients will lose coverage," "22 million people will lose their health care," "it's about tax cuts for the rich," and "Republicans just want poor people to die." None of that, said by Democrats, was true. It IS consistency, of a sort.
That the Republicans failed to come up with anything good to add to the ACA is not the fault of the Democrats.
Moose
That the Republicans were unable to PASS "anything good" is entirely the fault of a Democrats united against any change, while offering no positive proposals of their own. At least Democrats are now arguing (falsely, one presumes) that O'care could be "improved" with "bipartisanship." It's a strange definition of the term. We would now have repeal if just ONE Senate Democrat had joined Republicans to make it a bipartisan bill.
"We would now have repeal if just ONE Senate Democrat had joined Republicans to make it a bipartisan bill."
Thank heavens for principled Senators. It's a shame that only three Republicans are in that category.
Moose
Hi Moose,
"good and principled" definitely fit the old saying...
"Beauty is in the eye of the beholder" in this case.
The Democrats want to take money from the Peters to pay for the Pauls health insurance.
The GOP wants to allow people to carry no or too little insurance so that society will need to pay their bills when something bad happens.
And neither of them are creating policy to pressure people to lose weight, exercise, control their sugars, cholesterol, triglycerides, etc... The things that cause much of our chronic healthcare problems and costs.
"And neither of them are creating policy to pressure people to lose weight, exercise, control their sugars, cholesterol, triglycerides, etc."
Leaving people destitute with no option for preventive care (the Republican plan) will lead to more problems. The Democrats' plan is better in that regard.
Moose
Barely... I had great preventative care but I never took my blood numbers, weight, etc seriously until they were going to cost me $3,000 / year...
Somehow we have to help motivate people to change their lifestyles... Just paying their medical bills is not going to do it.
So, apparently the difference between the Moose liberal and John moderate positions is that the liberals want to FORCE people to buy something they cannot afford, don't want and can't use, and the moderates want to FORCE people to change their lifestyles so they don't cost so much. How about: You should be able to get all the health care you can pay for, and if you want to buy an insurance plan that is actual insurance-- say for catastrophic risks and you pick up the little stuff-- you can get what you want, across state lines even. And the government and private charities (and emergency rooms) will offer you health CARE regardless, but we will try to collect from you wherever possible. In other words, an essentially free market where costs come down, more people get what they need, and government stays out of all those personal decisions.
It is so sad that Democrats are willing to see the entire Obamacare marketplace collapse, leaving millions with no options and no insurance, rather than allow people to CHOOSE something that might serve them better and at lower cost. I think we're all feeling a little like Charlie Gard's parents.
And when The Total Failure occurs, watch Democrats blame Republicans for not preventing it from happening.
"And when The Total Failure occurs, watch Democrats blame Republicans for not preventing it from happening."
No. Republicans are actively working to make it fail.
Moose
Jerry, For better or worse our society is reluctant to let people bear the full consequences of their bad choices, so it only makes they be forced to help pay for the care they may need.
Now if we would be okay with letting them die the street, then let the free market rule.
Moose, Agreed. The GOP needs to make it fail or they lose credibility.
That is why they have fought making minor improvements for 6 years.
I think most voters are growing to understand this.
OK, the GOP has proven themselves completely unable to stop Obamacare, even including the illegal "tweaks" to prop it up. So how on Earth, when TTF occurs, is the GOP responsible? And the companion question, why are the Democrats insisting that everything is beautiful, and why must we all suffer through such a catastrophe while they turn a blind eye or three to the absolute and total mess they have created? How deep must the Titanic sink before the Captain says "oops"?
Remember that ACA is Terrible Until It is Compared to the Options
Politico Voters Oppose Straight Repeal
Hill DEMs Propose Fixes
The reality is that ACA is like a car that needs an alignment and some maintenance. The DEMs have made it clear that they are up for doing this...
The GOP is refusing to do the work... So when the tires are shot, they will own the problem.
John, your three previous posts share one thing in common. All of them are either woefully ill-informed, misinformed, or at least under-informed. We have a republic rather than a direct democracy because the average Joe just has no clue about all that stuff the goes on in Washington, and asking their opinion doesn't really give us any information. We can say it shouldn't be that complicated, but even at its best it's more complex than most all of us have time for. For example, most want to keep O'care because they don't want Medicaid cuts. There are no Medicaid cuts in the original bill. And they don't want repeal because they've been TOLD they don't want repeal.
As for the Democrat proposals, note they were not offered as amendments to any of the GOP bills, that only 10 Democrats are proposing them, that they consist mostly of throwing more money at the problem-- "bailouts for insurers"-- and they again promise to do what Obamacare promised to do in the first place and has failed to do. Face it, it's all politics with the Democrats, and the public be d**ned.
Jerry,
The reality is that workers like me don't care about the healthcare fight... ACA made little difference in my life... It seems to have the most impact on the low income, high income, self employed, and pre-existing condition folks.
And for the most part all it does is:
- taxes the wealthy and system
- forces more people to pay into the pool
- ensures insurance policies meet basic requirements
- reduces the cost for the low income, pre-existing and older folks
It really is not that complicated.
The folks who support it think the above make sense.
The folks who disagree think it does not make sense.
If it's not that complicated, why did it take 2200 pages and tens of thousands of regulations to make it work? Why didn't the website work on day one?
It taxes EVERYBODY, because it taxes providers of health care who, obviously, do not absorb that cost but pass it on.
It forces people to pay into the pool, except for the millions who refuse to buy what they don't want, can't afford and can't use, and "choose" to pay the penalty for for the "privilege" of NOT having insurance rather than buy the insurance. If you can make sense of that stupidity, please explain it to me.
It ensures that insurance polices meet outlandish lavish requirements, driving up the cost unnecessarily for any and all people, and it restricts innovative policies like HSAs, prepaid care, etc. that cost far less.
And it reduces the costs the "poor" pay, but SOMEBODY is paying the ever-rising total costs of care and it isn't producing any increase in quality or quantity that would justify the increased cost.
And it DID cost me the plan I had, liked and wanted to keep, but I would like to think I can care about all the others adversely impacted by the ill-conceived monstrosity, which did not enjoy majority support even at the time it was passed. Only now, after endless horror tales told by Democrats who will never admit their mistake, do we find the uninformed and mis-informed showing some support in the polls. The facts are the same as they were from the get-go; it's a bad idea whose time should have never come.
"2200 pages and tens of thousands of regulations" Source please. And yes the lawyers were involved...
New web sites and products often have glitches. Where is the surprise in that?
As I said... "- taxes the wealthy and system" And yes we tax payers and healthcare system users pay for this.
Yep. It does make people pay their fair share... Kind of like payroll taxes.
Your plan sounds like it was inexpensive. Often this means limited in scope and payout.
Source? look it up, it's common knowledge and public knowledge.
New web sites have glitches. Vast government programs and incredibly complex websites have massive failures and ongoing shortcomings. It is the nature of the beast.
And don't criticize my plan. It suited me perfectly and still would, were it legal. Much better than the alternative I was forced to buy. You are assuming that O'care delivered on all its lofty promises and that's as imaginary now as it was when it was passed. Good intentions do NOT make good policy.
I am not criticizing your plan... I am questioning your plan and how it would have handle a terrible chronic and/or expensive diagnosis...
These are what are really expensive.
"Eighty-six percent of the nation’s $2.7 trillion annual health care expenditures are for people with chronic and mental health conditions."
So your suggestion is that those with chronic conditions should just die and save "us" the money? How "death panel" of you. And of COURSE the most serious diseases cost the most to treat, and cause the most deaths. I'm pretty sure most car insurance costs go to fixing up people and cars who have the worst accidents.
As for my plan, my son broke both legs and spent three weeks in hospital, with two surgeries. My total bill was like $12. Under Obamacare, my guess is my bill would have been closer to $10,000. I prefer what I had. It's why I said a simple repeal, leaving me with what I had, would be a MAJOR improvement.
Again... Your sons condition was simple... Not chronic or complicated...
I wonder how he and your pocket would have fared if he had developed a significant mental illness or debilitating chronic health condition.
Actually I don't want them to die...
- I want people to pay enough into the pool to cover their share of the future costs
- I want people who make unhealthy choices to pay more into the pool.
I would say you are grasping at mighty thin threads by suggesting my plan wasn't what I liked and wanted to keep and implying that, somehow, Obamacare is better. It is not.
And your desires for our national health care system, likewise, may be marvelously utopian dreams-- frankly I don't care what they are-- but bear absolutely no resemblance to the Obamacare we now have and need to rid ourselves of.
Proposing the "replace" before dealing with the prerequisite "repeal" just seems to be getting the cart before the ox.
I am not "suggesting my plan wasn't what I liked and wanted to keep".
I am suggesting that it was not full featured and robust enough to cover your family's expenses if something really serious, chronic and expensive had occurred.
Of course people like paying less today for their coverage, and are easily capable of rationalizing the coverage will be adequate...
And I am saying that you do not have nearly enough information to even suggest such a deficiency. Furthermore, the only reason for such a suggestion is to imply that Obamacare would be somehow better, and I simply cannot imagine that being the case. In fact, in the situation I cited, my bill was about $12, and under Obamacare it would have been close to $10,000. Now if you can somehow rationalize that sort of cost differential as "better," you are a better mathematician than I...
Of course I do... If such a miracle program had really been as good as you think...
More companies would have had it...
And in most cases one gets what they pay for... And if you were not paying much it is unlikely there was much depth to the plan...
Baloney. The plan was roughly equivalent to the plan I had prior-- the company called them equivalent-- and the only difference was the paperwork and delivery system. And again, the only reason your are bad-mouthing it is to say Obamacare is somehow "better." Regardless of the respective coverage, you cannot say that because it was the plan I liked and wanted to keep. Neither you nor heavy-handed Democrats get to tell me they know better what I want and need.
"Neither you nor heavy-handed Democrats get to tell me they know better what I want and need."
Actually since you choose to stay living in this country... The majority of citizens in this country do get to tell you what you can have, if not what you like... Well I guess a democracy is a little better than a dictator saying what you can and can not have.
Ah, but the Republicans are now the majority, so when do I get to tell you that I want my plan back? And since when does a "majority" get to tell me what I must buy, what it must contain, and how much I must pay for it? Is there such a thing as a democratic dictatorship?
All I am asking for is economic-- specifically health care-- freedom. Why would you object to that?
The same reason I agree that drivers must carry a certain level of liability insurance. I don't want your freedom costing others.
Explain that. In my view, it is Obamacare and government-run health care that is costing others. It costs all of us because we pay taxes to support a system that is expensive and ineffective and denies choice, and it costs providers because they spend more time on paperwork than they should, and the time and quality of care suffers along with their rightful reimbursement. They could treat more patients and make the same money, but they are not free to do so.
In my view, my health care is my responsibility, and you are responsible for yours, just as you and I are responsible for acquiring our own food or shelter. If I choose to buy insurance against some or all of those costs, that is my choice and, again, my responsibility. No one else is harmed whether I am insured or not; my inability to pay for my ill health falls on me alone. Or should.
The case of automotive liability insurance is completely different. In that case, my irresponsibility has a very good chance of causing harm to others. But if I refuse to carry collision insurance, that is NOT mandated by law; I am free to choose or not choose, since the costs of my "irresponsibility" fall entirely on me for such incidents.
Jerry,
"my inability to pay for my ill health falls on me alone. Or should. "
Well unfortunately a long time ago someone promised that people in the USA would get healthcare whether they had paid their insurance premiums, saved for a rainy day or had done nothing at all...
So just like a driver who is not carrying liability insurance and is poor, the other citizens end up paying the bill.
And yes irresponsible / lazy people cost all of us every day. At least we now know about how much they are costing us. And maybe someday you will want to get serious about disuading them from having children they can not raise by themselves or well.
I'm serious about dissuading the poor and unmarried from having kids right now. I propose we reward two-parent family formation, both in law and in welfare rules, as well as with any sort of "moral re-awakening" we can generate in the churches and schools. The other thing I want to do is to encourage work and economic betterment for the poor, since that automatically leads to smaller families, with economic and social growth following.
And that "someone" who made those promises ought to be paying for them. You are correct, though, that "irresponsible / lazy people cost all of us every day." Especially Congress.
Sorry, I just don't see it.
You don't see /what/, exactly? I know what seems obvious to me is not necessarily obvious to others whose information processing and knowledge style differs. But unless you can explain your objections in rational terms (including if necessary the aforesaid learning style), I am inclined to believe you are just being stubborn or deliberately obtuse. Or perhaps I am just not being clear; feel free to ask for clarification.
To clarify... I don't think you are "serious about dissuading the poor and unmarried from having kids right now."
And I think you have your chickens and eggs backwards... People become more economically well off when they have fewer children in our modern world. Remember all those wealthy DINKs out there... (ie Double Income No Kids)
Having children has some great perks, but they sure are financially draining.
I said I was serious about it; I just don't have the power to make it happen. Government doesn't really have the power, either, for the most part, to make it happen, but they can in many cases switch from encouraging that irresponsible behavior to encouraging the more responsible behavior.
I do NOT have it backwards. Look at what happens to the birthrate as any nation's economy grows. It falls. And even where there are already "too many" kids in the family, having one or both parents find good-paying jobs prevents future additions and allows them to better care for the kids they already have. Why would you object to that?
Of course the government does not have the power to make it happen since Conservatives like yourself fear government and Liberals think people should be free to have as many babies as they want...
And then they just raise taxes to enable more payments to the irresponsibly folks.
Please explain this very strange leap of logic... "good-paying jobs prevents future additions"... Is it some new form of birth control that I have not heard of previously.
Government does not have the power to change the attitudes of people in poverty, nor to give them meaningful jobs (without displacing union workers, at least). Just as with the economy, government cannot make it grow, but they can certainly put obstacles in the way of economic growth, they cannot lift people out of poverty, but they can sure quit putting obstacles like "free food, clothing, shelter AND HEALTHCARE" in front of them in exchange for no effort or change.
There is no leap of logic, here, it is proven fact. In what sectors of the economy do you find the highest and lowest birthrates? Simple-- working two-parent families do not have time or money for additional kids, and single-parent unemployed folks tend to have bigger families they cannot afford. So long as government gives them more money for the additional kids, why not? Get those folks a job, require both parents to kick in for the support of their kids, offer free birth control if you want, free child care if you want, free education they already have, but maybe pay them to take it (isn't that ridiculous). Heck, I would even say government should pay for your very simple wedding! In short, government should encourage the responsible behaviors and quit subsidizing the opposite.
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