Friday, March 10, 2017

Details, Details

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Donald Trump and the Republicans have rolled out their initial plan to repeal and replace Obamacare, but for many Trump voters the plan (the first of three steps intended to address all aspects of reforming the ACA) isn't finding acceptance.

Why? Because they know (correctly) that Obamacare is riddled with serious problems and is harming our healthcare system and they voted to get rid of Obamacare in its entirety. And that's by God what they want!

Unfortunately, the reality of the situation is very much akin to the scenario depicted above: if you simply cut out the problems all at once with no replacement ready, the patient will die. And in this case, the bloodsoaked, flailing patient happens to be your health insurance.

We can't simply return to "the way things used to be" because Obamacare destroyed that system. It's gone. Kaput. It is not simply pining for the fjords, but has joined the choir eternal. Which is why doing an immediate and total fix is practically and politically impossible.

Rather, we need to accept (unhappily, and perhaps with an adult beverage in hand) that the Republicans only have two choices right now: a series of slow and messy patches to Obamacare that will gradually push the insurance industry back toward free market solutions, or a quick amputation of Obamacare in its entirety which will accelerate the industry's crash and make single-payer care inevitable.

We don't have to like those choices, but to deny that those are the choices can only lead to disaster.

42 comments:

Ed G. Mann said...

What do you mean No choices? First off, what in hell is the Government doing in the private sector anyway? Ryan should have been busy getting the Feds out of the health care business.

Since he elected to screw around with that bastard of a law anyway, all he had to do was keep the kids in Mom's basement on their insurance till 26 and keep the pre-existing conditions conditions clause current. After that, you want insurance, you buy insurance. Buy it at 25, here's your premium. Buy it at 55 now you pay this much. Have a "mild coronary", well now, we'll insure you for this rate.

Buy Major Medical and pick the deductible you want, 5%, 10%, 15%, 20%. Just like car insurance, that modifies the premium; pick the amount of coverage $100,000, $200,000, $500,000 also will change your outlay. Major Med has a minimal hospital benefit. You're not going to get a private room or nurses with big boobs either.

So what does Ryan do? He puts the Insurance companies in charge of telling you when you have to cover yourself or you are not insured. 63 days was the number picked. Why not 60, 35, 2, or 18. Why are the insurance companies even getting to have a say.

Everything the Government touches turns to crap and this will be no exception.

And if you want a real shock, have a real claim for something like liver cancer requiring a transplant. The moment you exhaust your insurance policy, see how fast they drop you. Then try to get insurance with a pre-existing condition at whatever age. You're HUMP. Just bend over.

Anonymous said...

Hogwash. Repeal it. The damage that could result would be far less than Obamacare has caused in the past 7 years.

RINOcare is 33% fewer calories, same great taste. Or would you like to invest with a Nigerian prince in a sure thing?

Phssthpok said...

When the fire department rolls up to put out a burning house, they don't first decide which other structure to set on fire to replace it.

Obamacare was rammed down the throats of the American people by the democrats without one. single. republican. vote.

Yank that damned thing off like the dirty festering band-aid it is. Sure it'll sting like the dickens at first, but it's the best way to get it over with.

James Daily said...

I believe we have these problems because of the do nothing congress. They lied to us repeatedly, give us a majority. . . bull hockey. This was too important to do nothing about but that's what they did. Now, the ball is firmly in their court and they do not know whether to sheit or go blind. I am very sick of these elected. Even with some miracle if the house does something that will work, we still have that asswhole McConnell (yea, totally ass) to contend.

Dick Lowman said...

I don't normally join in the fray here, but this is one of the rare occasions wherein I disagree with the blog comments. Can you name one similar federal program that hasn't evolved into a horribly mismanaged welfare program? Consider Social Security, Medicare, and Medicaid. All well meaning at the inception. All originally had "justification." Now those of us who have paid in all our lives are receiving back only a fraction of our investment whereas many bureaucrats are enjoying luxurious salaries and many who haven't paid in are receiving benefits they haven't earned. Yes, repealing Obamacare will create problems that didn't exist before that monstrosity was forced down our throats, but those problems will be far less than the long term disaster we face if Ryan and crew passes Obamacare Lite. And yes, in theory, an incremental fix has some merits. But do you trust our Congress, (the same Congress who intercourses-up virtually everything virtually everything they touch) to truly fix it?

Ray K said...

For years the Republican Congress has voted for a simple repeal (more than 40 times), knowing full well that the Senate would never allow it to pass, and if it did, Obama would certainly veto it. Now, when the vote would really count, they fear a 'simple repeal'. roflmao. They were/are no more serious then than they are now.

There is a 3rd option; do nothing and allow the system to finish collapsing. Then, when you have everyone's attention, allow the free market, across state lines, to do its job.

Jim Irre said...

The Constitution says, "provide FOR the general welfare" not provide welfare. These idiots need to learn how to read. It also doesn't say anything about the Fed doing many of the myriad things they do and screw up on a regular basis. While we're repealing O-bend-over-and-hold-the-sand-filled-vaseline, let's repeal the 17th amendment.

Oh, in case you hadn't noticed Stilt, you're outnumbered.

Fish Out of Water said...

Sorry, but fully agree with our host. Sure Congress could enact wholesale repeal, leaving those who have used Obamacare out in the cold and thereby inviting a political disaster in 2018 that probably would see the current Minority leader and House dingbat, Nancy Pelosi, et. al. controlling the House and the weasel of the Senate, Schumer, leading the Senate. And the way things were was not perfect. An insurer could deny coverage due to a preexisting condition. Tort reform was/ is needed: a late aunt of mine, who was a physician, had to as she became older, drop her practice as her malpractice insurance became too burdensome.

I too believe Obamacare is a bastard child, but replacing it or just allowing it to collapse will have consequences, the last and more important/sinister is what I and many believe that Obamacare was never meant to work: the true goal was and still is for democrats is the single payer/nationalized healthcare.

Full Sail said...

Stilton, I find myself agreeing with you completely. And being outnumbered is never a substitute for truthful analysis. I happen to want Trump around for 8 years, not 4 or less. Obama meant for this system to be unfixable. As you have been personally impacted by this atrocity of a law, it would seem that you would want quick remedy not slow duct tape patches. Be patient me conservative colleagues, this will get sorted. Trump actually has a heart and it is a combination of warrior and fox. He learned from his first executive order on illegals from dangerous countries, that you have to move carefully and anticipate the reactions of crazy liberals. Fun to be at Stilton's Place!!

Geoff King said...

I don't understand why anyone believed that the Republicans would do better by us and our healthcare than the Democrats did. Speaking as a Libertarian, they are both the same party-the Republicrats.
Until we have Constitutional Ammendments requiring term limits and that congress abide by the same laws they force on us, it will always be "a government of the government, by the government, and for the government"

Fred Ciampi said...

It's hard to disagree with anyone on this forum because all have such good points. There is one thing that hasn't been said though. "Buck O'Fama certainly has left a legacy, and that legacy is the most f**ked up piece of legislation ever to darken our collective doors". I think that all of us can agree on one thing; and that's something we would all love to see, on international television, prime time, obama-the-legacy-builder being led off in handcuffs to the (take your pick). Oh, there would be dancing in the streets and much more.

Emmentaler Limburger said...

I heartily disagree.

If the ACA was repealed in total, and the state line issue regarding insurance sales was struck down, the insurance market would surge, putting us pretty much back to "the way things were before Ă˜bamacare." If this were quickly followed by reforms - for instance: a tightening of the extremely loose laws regarding just what you can sue the entire medical food chain for - improvements in cost will follow as the medical system's insurance costs decline. Let the pre-existing-condition and children-in-the-basement clauses stand, and regulate what can be charged for them, relative to "normal" policies, if you must - this bit of government meddling where they don't belong will likely bump up insurance costs, but if they finally patch the major holes in the medical/medical insurance boats - negligence tort law reform and requiring an insurance company to maintain an office in the state of insurance sale - we'll be better off than even before that abomination was crammed down our throats by a liberal majority in WDC.

The only true "risk" to doing so is to those that participate as contestants in that popularity contest we call "elections." However, I counter that the majority of those actually affected positively by Ă˜bamanation Care don't vote, and the contestants will only need to face the wrath of those liberals who are always so willing to give away other people's money. Notably, they'd never get their votes, anyway.

Finally, the government empowering a company to force you to buy something is no different than the government forcing you to buy something. Actually, it's much, much worse. So much for personal liberty...

Fish Out of Water said...

@ Emmentaler Limburger
"Finally, the government empowering a company to force you to buy something is no different than the government forcing you to buy something. Actually, it's much, much worse. So much for personal liberty..."

But the the federal government has already done this well before Obamacare. Don't believe me? The next time you open your vehicle's door, look inside. The seat belts and airbags- and for newer models, backup cameras, are things the federal government has forced you by law/regulation to buy.

Emmentaler Limburger said...

@Fred Ciampi I think he should be president of France. They deserve him.

Emmentaler Limburger said...

@Fish - True, and demonstrates my point, but in a different way. You also have no choice but to wear that seatbelt due to coercive pressure from the DOT - if local police don't enforce seatbelt laws, the state loses money for the roads. Would the Takata airbag deaths have occurred if everyone wasn't forced to put airbags in their vehicles? Likely not, as they would never have been producing the volumes that led to the degradation of the design of the airbag (eliminating the waterproofing of the inflator can coupled with poor sealing - both likely driven by process efficiencies).

There are several consumer areas affected by torte law, too: those long sections of warnings that come with any product because some asshat managed to successfully sue McCullough (or Poulan, or Homelite, or Stihl....) after injuring himself while juggling running chainsaws, for instance...

GenEarly said...

The USSA is stuck between a Rock and a Hard Place. Much of the population, including our illegal residents, are on Welfare of some sort. The "Welfare" of FDR is now an entitlement and protected by present day conservatives. Not to lay too much fire and brimstone on the current conservatives, they are just victims of the ProgreSSive tide ever since Woodrow Wilson that has never ever really receded, only pausing slightly for a couple of administrations.
The problem is how to get the people and corporations and universities off of Government Crack
Cold Turkey? Ever tried it? Could the country survive the shock? or Methadone? Worse (it is the previously planned single payer solution) or a 3 step planned program that historically never happens?
Income Tax was "temporary" and started at 1%...... Empires never learn and never return to their Republic starting point; Just a Fact that is chipped in the stones of Rome.
But it's human nature to "Try" it's just that the "Do" didn't even happen in prior generations that were far more self reliant and Tough.

Stilton Jarlsberg said...

@Readers- Looks like we've got a live wire topic today! Before I dive in to some replies, I'll just underscore that the scenario I described in the commentary isn't what I like in the least, but simply what seems to me to be the unpleasant reality we need to deal with. And now, on with the show!

@Ed G. Mann- I agree with pretty much everything you're saying, though the key point we should talk about is "what the hell is the Government doing in the private sector anyway?" You're exactly right - they shouldn't be there - but after years of Obamacare being in place, there's no "free market" to return to. That too gives the Republicans two choices: try to create a new "free market" by government edict (yes, that's oxymoronic), or shut down Obamacare with no existing free market alternatives and watch the Dems sweep the midterm elections.

@Anonymous- The "damage" would likely be a midterm tsunami in favor of the Democrats, taking away our (already slim) chances of making even incremental improvements to Obamacare, the economy, immigration, national security, and more.

@Phssthpok- The fire department metaphor, while catchy, doesn't really work. If the firefighters put out the blaze before everything is consumed, then what will happen next? Repairs and patches to make the house functional again. That's what we're seeing now regarding health insurance: the (sloppy) repairs and patches.

And emotionally, I agree with the idea of ripping the bandaid off. But the political reality is that our side would be crucified for it, and not without some justification.

@James Daily- There is no love in my heart for Republicans, I assure you. And yes, we've been lied to again and again. But I'll gently disagree that the plan currently being floated is "nothing." It's not enough, and it's not satisfying, but the political reality (which should in no way be confused with rational reality) may be that it's the most we can get at this moment. Don't think of this as the end game, but rather the start of a process which can produce better results (and bigger changes) in time.

@Dick Lowman- Good comment, and I can't disagree with 99% of what you're saying. Yes, government programs make everything worse. No, I do not trust Congress to fix things. I hate the reality of where we are (and is exactly where the bastards who wrote the Obamacare legislation wanted us to be) - we are truly damned if we do, and damned if we don't. While I'd love the emotional satisfaction of nuking Obamacare from orbit ("It's the only way to be sure"), it's unlikely that a free market replacement would rise up from the radioactive ashes in time to save us from the slavering, double-jawed, acid-blooded Democrats in 2018. And sorry for the extended "Aliens" riff, but I got the wind in my sails (grin).

@Ray K- I agree that the "transparency" we're currently seeing is that the previous Republican bills to repeal Obamacare were just political theater. The bastards. But the 3rd option you mention - letting the system fail (as it is designed to do under Obamacare) and let the free market pick up the pieces - is never going to happen. "Failing" really translates into tens of millions of people losing access to healthcare and then demanding (not surprisingly) that the government "do" something about it. That something could only be single payer care. This is, in fact, the actual blueprint of Obamacare and what the Dems' goal has been all along.

I want a return to free market solutions, but we can't get from here to there without some sort of bridge.

Fish Out of Water said...

@ Limburger. Your point about airbags, and automatic restraints in general strikes a chord. First it was former Senator Timothy Wirth, who had a bill passed by Congress that mandated airbags. DOT only did what Congress ordered it to do. Second in the long regulatory battle of automatic passenger restraints in vehicles,there was and probably still is, a section in the federal regulation on occupant restraint devices, FMVSS 208, now obsolete, that stated that by (whatever date)if 2/rds of the U.S. population as per whatever census was referenced were covered by seat belt use laws which met 3 criteria: 1. that non-use was a first offense. 2. the fine had to be a minimum of (?) and 3., which I have forgotten, then the automatic restraint requirements set forth in the regulation would be null and void.

Given this, why then efforts were not made of have individual states pass seat belt use laws that met this criteria, which would have put the entire debate about automatic passenger restraint to rest, has been a mystery to me.

Stilton Jarlsberg said...

@Jim Irre- Man, I am outnumbered this morning! (grin) Fortunately we're all friends here, who can disagree without being disagreeable. You're right that the government shouldn't be in the business of providing welfare for everyone, any more than they should throw out our right to "the pursuit of happiness" and replace it with a "government guarantee of happiness."

Mind you, I hate the position we're in now. But can anyone here who is finding fault with my logic describe a scenario in which immediate and full repeal of Obamacare, with no replacement, would not result in a devastating political backlash which would re-empower the Democrats? I'm genuinely asking.

@Fish Out of Water- Yay! The reinforcements have arrived (and just in the nickel dime)! One of the things I'd love to see (and NOW, dammit) is tort reform which would help reduce insane insurance costs to doctors which get passed along as charges to patients. That could help bring medical costs down immediately, with no cost to taxpayers. Bonus: it would piss off innumerable lawyers, which makes it worth doing just for the pleasure of seeing the look on their faces.

@Full Sail- Hopefully anyone who's read my previous experiences with Obamacare knows that I hate the system. And I also hated the system before Obamacare when I had to pay premiums that were through the roof for a (self-employed) family of three...two of whom have epilepsy. We actually needed health insurance reform at the point Obamacare took wing. The problem is that Obamacare wasn't "reform" - it was designed to redistribute wealth and, as you point out, fail and be unfixable in order to force single payer care (which itself isn't about "care" but about control).

I actually believe that Trump and Ryan are trying to do the right thing, as opposed to the emotionally satisfying (in the short term) thing. Let's give them some room to work - if things don't move in the direction we want, then we can tell them at the ballot box in 2018.

@Fred Ciampi- You're absolutely right that Obama (cursed be his name) is at the center of this mess even though he gives the illusion of being offstage. I would love to see that SOB charged with crimes and sentenced to Gitmo.

@Emmentaler- Again, I agree with almost everything you're saying but with a couple of exceptions. I think people will demand that previous conditions and kids under 26 are guaranteed coverage, and to accomplish that the insurance companies will have to raise their rates a lot since healthy people (and irresponsible ones) will drop out of the system.

It's that "previous conditions" thing that really messes up the finances and my solution (sure to be vastly unpopular!) is this: don't insure previous conditions. Ouch, right? Give people with previous conditions a window to get insurance, but after that slam the window shut. Make it clear that if you want insurance to be there when you're sick, you have to buy it when you're healthy. And by "have to buy it" I don't mean via mandate, but by raising awareness of the fact that if you chose not to buy insurance and then got sick...you're screwed and it's your own fault.

@GenEarly- Beautifully said.

Dave Neumann said...

I stand with Geoff King on this issue. Wisconsin has 5.6 million people, and a FULL-TIME legislature. I believe only 9 states have full-time legislatures, and those have twice our population or more. Some of our legislators hold offices which were "handed down" to them from a parent. Others are related to each other by marriage or blood. Term limits is part of the answer. The other is to require that candidates had a "real job" prior to running (see the Kennedy clan). Working the night shift at a convenience store, and a foundry, being a farmer, etc. would make our legislators better than our current crop. Like my T-shirt says, "LEAVE NO INCUMBENT BEHIND."
Dave Neumann - New London WI

Pete (Detroit) said...

Dave, at the local (State) level we've had term limits for a few years now.
The main result being that no one in state house (either of 'em) has clue one about what the job 'should' be...
It's surely not the whole answer.
OTOH, it mandates a change in the Gov office every 8 years, and that's not such a bad thing...

As for Bummercare, burn down the house.
Anyone who thinks Gov't should provide health services at little / no charge is welcome to see the VA
Everyone else, pay cash, buy traditional insurance, join a group, what ever, lotsa options.
And hey, maybe VA would get some attention / funding...

MD Vickery said...

Obozo promised "Fundamental Change". Little Boy and Fat Man delivered fundamental change to Japan, too. The problem is that not enough people asked what form that fundamental change would take. The helpful sheeple translated that change into whatever they wanted it to mean and hoped for the best. What they got instead was "gubbermint assistance" Nagasaki style. Complete repeal requires 60 Senate votes. That won't happen without a Republican miracle in 2018. Which means 2019 before anything can happen. Obozocare will have imploded by then, just as the dummycrats expected. So now a band-aid is proposed to fix an aortic bleeder. There are a few simple steps that COULD be taken, many of them already mentioned - tort reform, interstate insuring, pre-condition assistance, etc. However - the gubbermint cannot comprehend simple solutions. Trump can, but he can't dictate to congress. Liberals trust only the gubbermint to help them, conservatives trust the gubbermint to screw things up. The gubbermint has - rarely - accomplished some good things. But most "gubbermint assistance" is best delivered to another country.

Emmentaler Limburger said...

@Stilt ...if things don't move in the direction we want, then we can tell them at the ballot box in 2018.

Reading this logic: same same. Damned if they do by mobilizing the left; damned if they don't by losing their conservative support. Midterms, barring a halo effect via the Trump administration, seem like they're gonna be a crap-shoot.

In any case, you ignore two factors in my argument: allowing interstate sale of insurance has the potential to greatly reduce insurers' expenses, and jump up competition. Today, insurers cannot sell products across state lines. The big national insurance companies must maintain offices in each state under current law. Removing the requirement, they can consolidate their staff (and increase unemployment and urban blight...). This also allows smaller, regional insurers an opportunity to expand into other markets without the expense of duplicating staff and leasing buildings. The current law mangles the free market by severely limiting competition in each marketplace.

Add to this that suitable reform of tort laws will reduce the insurance costs of the medical industry which should reduce expenses to the patients: elimination of unnecessary tests conducted as a CYA, for instance. This reform is, however, double-edged as the liability/malpractice insurance industry would likely take a hit.

All of this puts downward pressure on the insurance costs and, barring dishonesty on the part of the insurers, the premium. If insurance premiums become affordable through such actions, more self-sufficient people who before refused to insure are likely to enter into the market, and more businesses may choose to offer it to prospective and current employees as an incentive to stick around. Other medical industry costs - for instance: write-offs due to nonpayment - may be reduced as employers are no longer incentivized to cut employees' hours below the must-insure threshold.

The question should be whether these forces overcome upward pressure the expense of a "prior conditions" regulation. Personally, I think they would have a positive impact.

And there are many other things that can be done to reduce medical costs, too. Things to increase competition between healthcare providers for your business, for instance. Having them focus on costs and eliminate the massive waste within most, if not all, hospital management and administration...

Also, though I don't condone it, the states can individually require health insurance, just as they require auto insurance in order to register a car or motorcycle (in MI, we're also required to have coordinated medical coverage for both...). All powers not assigned to the federal government...

Anyway, have to get back to work. Glad to have this venue to vent my spleen :)

Stilton Jarlsberg said...

@Dave Neumann & Pete (Detroit)- You guys have got the issue of incumbency surrounded, and I don't disagree with either of you. I like the idea of term limits to the extent that it would encourage politicians to do the right thing instead of always being guided by "how will this affect my next election?" But on the other hand, constantly shoving politicians out the door means greater reliance on the "deep state" players who don't get rotated out. In other words, I don't know what the hell to do (grin).

@MD Vickery- Much truth in what you say, and I particularly focus on your phrase "the government cannot comprehend simple solutions." It's true- they don't trust either the people or the free markets to solve most ills, and instead are always metastasizing in order to control things.

@Emmentaler- Excellent points across the board, and I don't think I ignored the two critical factors you're reiterating. As I understand it, the things you refer to (interstate insurance sales, etc) are part of the grand plan that Trump and Ryan are working on, but that it's going to be a several step process. The bill on the table is not acceptable if nothing else is planned. But more is planned, so as anxious as I am to see a complete overhaul of the current mess, I'm willing to let it come in waves if there's no other way to make it happen.

Mark Matis said...

I believe you will find that there are a number of group insurance plans that covered pre-existing conditions BEFORE Obamacare. I think that one of them is the Federal Employees Health Benefits Program (FEHB). The government negotiates with insurance providers in areas across the country, reaches a cost and benefits agreement with each of them, and then offers those plans to the Federal employees. Now the employees have their cost partially subsidized by the government, but there is a full cost accepted by the insurance company for each policy. Why not offer THOSE plans, UNSUBSIDIZED, to every citizen in this country? To the best of my knowledge, the government does not force any company to participate in the program. And the companies voluntarily accept the negotiated payment for their services. What's wrong with that???

John the Econ said...

"Rather, we need to accept (unhappily, and perhaps with an adult beverage in hand) that the Republicans only have two choices right now: a series of slow and messy patches to Obamacare that will gradually push the insurance industry back toward free market solutions, or a quick amputation of Obamacare in its entirety which will accelerate the industry's crash and make single-payer care inevitable."

Sigh. Unfortunately, you are completely right, @Stilton. That's the reality, and most Republicans know it. Otherwise, they would have been spending the last 6 years on a viable alternative to have ready for last January 20th. Alas, they did not.

ObamaCare, the intentional virus, has long since damaged the health of the host beyond its ability to recover. The insurance I liked (high deductible, but paid 100% after that for about $400/mo) and the doctor I liked are both long gone, and will never be coming back. Now that Mrs. Econ & I are in our 50s and roughly a decade out from MediCare (the age where stuff starts to break, get attacked, or just wear out) there can be no "free market" insurance that could be expected to carry us for any amount that we could afford. There simply isn't enough time left for any honest "free market" offering to make any money off of us before the actuarial tables suggest that we'll likely to start making expensive claims that will easily exceed any amount they could collect from us in a mere decade.

On various sites whenever any of the GOP dreamers keep saying that the "free market" will happily replace ObamaCare, I point out the above and wait for their answer. They never do. I'm not surprised.

If I was the GOP, what I would have done is let ObamaCare run its course. Most of the exchanges are collapsing or gone anyway, and if nothing is done the rest will be gone in a year or so. That should put an end to all those people who say they're actually happy with ObamaCare. Not only that, I would have forced the Trump Administration to enforce ObamaCare as originally written. That's right. Force everyone to issue 1099s on everything they bought at Office Depot. Make them live Nancy Pelosi's nightmare. None of the phony and illegal "fixes" applied by the Obama Administration. When people complain, then say "Well, this is the law passed exclusively by Democrats and signed into law by Barack Obama. If you don't like it, bet mad at them." Suicidal? Perhaps. But it's where we're all headed anyway.

Shelly said...

It would give me some comfort of our so-called representatives were working on a solution with OUR best interests in mind. Unfortunately, every step they take has one eye on the next election and the other eye on the powerful lobbies pulling their marionette strings. Off topic, I realize, but I think this country would be a lot better off if those lobbies were broken up. I know, I know, who would fund reelection campaigns, right?

Paul D Garber said...

Actually they have a 3rd choice. Let ObamaScare continue on it's ruinous path & completely collapse. Then it will be the Democrats problem Maybe then they can get airheads like Mummy Pelosi (remember as part of the mummifying process the brain is removed via the nose leaving nothing but air between the corpses ears) to actually cooperate in fixing our Health Care system. I just wish they would do it with a bunch of small bills which could be worked simultaneously (which they could have been doing now; Sigh).

Colby Muenster said...

As much as I would love O'Raghead's idiotic and destructive "healthcare" law to be torn up, shredded, burned, compacted, then launched to a moon of Saturn, I have to agree with Stilton and Mr. Econ. The chances of the free market rebounding are certainly real, but this could take years. In the meantime, chaos would ensue, and progressives would regain power in the very next election. Bye bye freedom, folks. Bye bye any hope of regaining ANY the Constitutional rights that the Progressives have stripped from us over the last few decades. Not that I have huge amounts of faith in the current administration, but it's the best hope we've had since the 80's.

It leaves a nasty taste in my mouth to say it, but the duct tape and bailing wire approach may be the only way to even have hope of getting rid of this crap. Total and quick repeal would no doubt result in single payer because our Stinkators and Reprehensitives don't posses the balls to stop it. Yes, the insurance companies would eventually recover to a free market system, but the howling libtards would not stand for the amount of time it would take (i.e. more than a week).

That being said, we need to keep pressure on our Representative's and Senator's to stay FOCUSED! OK.... we're semi-fine with the slow, methodical approach as long as they don't lose focus and get distracted.

How about they give us a timeline for completion? This year, we do this, next year, we do that, and so on. Nah.... makes too much sense.

JohnGaultcsa said...

So now, after years of empty, useless, GOP rhetoric, we learned that what they really meant by all that was: If you like your Obamacare, you can keep your Obamacare. Paul Rino's "Repeal & Replace" bill neither repeals nor replaces Obamacare. I can't say I'm surprised, but it seems the only thing we can count on more than there being no stupider people than republicans is the fact that there is no one more cowardly than republicans.
For 6 years we've sent these surrender monkeys to D.C. with one mission - to put a stake in the heart of this Socialist monstrosity. In 2010, when the Tea Party Movement gave them the House they said they couldn't because "they only controlled 1/2 of 1/3 of the government." Then they got the Senate and they whined that they were powerless without the White House. So now that they finally have that, too, what do they do? They give us RINO-Care: A more insolvent version of Obamacare - except this time GOP will own it.
These GOP morons had better listen up. As angry parents have been known to say to their unruly children, "we brought you into this world and we can damn sure take you out." We want Obamacare dead. We don’t want a zombie sequel operating under the same flawed premises and using the same central planning approach that permanently enshrines yet another unaffordable entitlement. We’re serious and if they have to be ritually sacrificed on the primary ballot box we’re totally OK with that. It's time they remove their heads from their collective asses – which is where I assume they pulled this plan from – and start doing what we damn well sent them to Washington to do.

Anonymous said...

They have no reason to worry, JohnGaultcsa. They understand how the electoral system works. Their One World Government overlords have the money to control the Media. Except for candidates who have the capability and will to fund their own campaign - like President Trump, for example - nobody can win without the support of the big donors. I keep hearing that "anybody could have beaten Hillary". And that is a load of crap. Trump won because his message resonated with the Deplorables, and he was able and willing to fund his own campaign. Songbird McCain won in Arizona because Kelli Ward simply did not have the $$$ to expose him for what he is. If the GOP had nominated Ted Cruz instead of Trump, Senator Cruz would have either had to embrace the One World Government espoused by the Rove Republicans, or he would have been unable to get his message out. Money is Speech today. And there is no sign of that changing in the foreseeable future.

Chrissy T. Hyphenated said...

Stilton, I have been a long time reader and often cross post you to my own blog @ http://polination.wordpress.com/. Today, though, given that I truly appreciated your insight and that you got dumped on, I decided to stop lurking and give you an Atta Boy!

Stilton Jarlsberg said...

@Mark Matis- Actually, I find nothing wrong with that. Nor do I have a problem with offering insurance for preexisting conditions through high risk pools. I believe there are free market solutions...I just don't think we can implement them immediately given the current state of the health insurance market, the political climate, and arcane rules about what can or can't be passed with the existing numbers in Congress.

@John the Econ- Well put! And while I like the idea of just letting Obamacare run aground (and even better, practicing it as written) we both know that the Dems would never suffer the heat from it. The Republicans would be blamed - falsely - but it would still stick.

By the way, no matter which side of the argument I'm on, I'm pessimistic about us ending up with anything other than single payer, reduced access to health care, rationing, and all the rest. A free market will only provide solutions for people willing to embrace their responsibilities - and I'm afraid I don't think that describes enough of the voting public anymore.

@Shelly- Amen. I don't care which party you're talking about, there doesn't seem to be a lot of motivation to help us instead of the politicians themselves.

@Paul D Garber- As I mentioned above, what you're suggesting makes a lot of sense - but the Dems wouldn't get blamed for the disaster. The media would savage Republicans, people who lost insurance (or loved ones) would blame the party in power, and the Dems would sweep the next election cycles. I wish that weren't the case, but it's what I believe.

@Colby Muenster- Eloquently put. Which is a darn good thing, because I'm on my third (crappy) scotch and water and my ability to bang words together is somewhat degraded (grin).

@JohnGaultcsa- I agree with sooooooo much of what you're saying. The GOP should have been fighting the good fight since 2010. It would have been ugly, bare knuckle stuff (hell YEAH let's shut down the government), but the health insurance market wasn't mortally wounded yet. But in RINO-ish ways, they screwed around, blustered and promised - and here we are.

That being said, I believe (hope? pray?) that what we're seeing is not nothing, but rather the painfully small start of something good. Am I confident of that? Nope. But calling it as I see it.

@Anonymous- Fine points. Money is speech these days, and those with fat wallets are calling the shots ("Same as it ever was," as David Byrne might say). I still consider it a freaking miracle that Hillary didn't win...and I'm grateful every day.

@Chrissy T. Hypenated- Attaboys and back slaps are always appreciated! But let me make clear that I haven't felt "dumped on" by a single person here today. I want this forum to be a place where people can amicably disagree. In part, because I always reserve "the right to be wrong." I do my best to share my honest opinions and perspective, but I've never represented myself as a genius and I'm always hoping to learn things from others who contribute here. Believe me, I'd LOVE to hear a convincing argument for ripping Obamacare out in its entirety right now, and I appreciate those who've tried to make that case here today.

I look forward to checking out your blog - and here's hoping that you make your voice heard here on a regular basis!

Dan said...

Why can't the "across state lines" thing be taken care of *while* they try deobaminization of the health insurance business (it's NOT health care).

As an aside, I don't trust Insurance Companies any more than I trust banks, which is zilch.

I have insurance because I'm required to by law (for the cars) and as a matter of protection (for the house) and to provide enough to bury me (life). For health insurance we have Medicare, Tricare for lifers, and I have the VA (for what it's worth).

I haven't had money in a bank for over thirty years now (I have a credit union I joined in 1976 or 7) and it's served me well from Maryland to Hawaii, and a half-dozen countries.

Judi King said...

After reading all of your intelligent debates, I'm more confused than ever. All views have their good and bad points. My wish is that the government would get out of EVERYTHING except national security and a few interstate problems as our constitution intended. I know this will never happen because too much power would be lost. I agree with Shelly, lobbies have pretty much destroyed us and @ GenEarly: Ancient Rome is my favorite subject and it's wonderful society imploded just as ours will. Rome took about 500 years to lose their republic and another 500 to implode, but ours will probably only take 300. Since history is no longer taught, the rising generations don't have a clue what they're in for.

Mark Matis said...

You may be right, Stilton Jarlsberg, but FEHB has been working for many years and the insurance companies do not seem to have a problem with it. And to the best of my knowledge, the FedGov has a higher at-risk population than normal society due to their Preferred Species agenda. Further info here:
https://www.opm.gov/healthcare-insurance/healthcare

Note that the plan rates shown identify the employee's cost and the government contribution, which is counted as part of employee compensation. Note the number of plans available. And also note that, absent the federal mandate for specific coverage, the plans have a wide latitude to define what they will cover and what the co-pay is for each option.

I would think that the government could choose to make that available to the general public at next open season, which occurs in the November timeframe. Once again, for people who are not federal employees, there would be no federal government contribution. But the individual states could decide to subsidize coverage for their citizens should they so choose.

Anonymous said...

Medicaid is not health insurance! Medicaid provides a card that allows you to get in line with a bunch of other welfare recipients hoping to find a doctor that is willing to provide his services for 29 cents on the dollar. And if you have equity in your home they will put a lien on it to recover what you cost them. This happened to mom when she was needing to put dad in a care home. Google it.

Beto Chile said...

I sometimes think that we forget that our political ideas and values do not exist in a vacuum. There is a panoply of ideas out there many of which are contradictory to our own principles. I think Democrats forgot about this when they rammed the ACA down our throats with zero Republican support and then promptly lost control of the House of Representatives and suffered losses in the Senate in the following midterm election. Some Republicans were elected by constituencies that uniformly believe in the full and expeditious repeal of ACA, but other Republicans serve constituencies that are a mixed bag in regards to views towards ACA. I would rather see the Republicans take a patient, measured, and perhaps even imperfect approach in repealing ACA to ensure that they can preserve and perhaps build upon their majorities in both houses of Congress.

John the Econ said...

"The Republicans would be blamed - falsely - but it would still stick."

But that was going to happen anyway, no matter what. That was part of the plan for ObamaCare from day-1. Anyone who refused to subsidize it further or resisted "single payer" was going to be the bad guy.

A year ago when Trump became the front-runner, I predicted that we'd end up with "single payer" before the end of his first term. He'll let the GOP play around with "repeal" or "ObamaCare lite" or whatever, but in the end it's going to be "single payer", and it's gonna be HUUUUUGGGE!

And ultimately mediocre, just like being on Medicaid. We'll ultimately have two systems, just like they do (but don't talk about) in most of the other "single payer" countries. There will be the "public option" which most of you will be stuck with, and there will be the "private option" that the rich will get, because they will be able to afford it. It's all part of the War on the Middle Class; Social justice because you'll be in the same boat with the "poor", but the elite will not have to suffer for it. But they will feel good about themselves for voting for it.

JustaJeepGuy said...

@John the E,

Didn't Obamacare have a provision that prohibited doctors from taking cash to care for a patient, even if he/she could afford it? Of course, the born-into-money Demo_Rats will, if that is the case, call doctors "employees", and get around the rules that we, the unwashed masses will be required to follow under penalty of (eventual) death.

John the Econ said...

@JustaJeepGuy, I don't think that's the case since post-ObamaCare, there's been the rise of "concierge medicine"; where people of means privately contract with doctors, usually for a set annual fee. It's something that I've certainly considered. Under any future plan, I'm very certain this will remain the case as the wealthy and elite class are going to need someplace to go as the "public option" devolves into a mediocre and rationed morass.

I do know for a fact that under the "HillaryCare" plan of 1994, that was certainly the case. In fact, it made most practice of medicine outside of the "system" criminal.

Again, tell me who the "fascists" really are in this country.

Anonymous said...

I am in favor of scraping ACA entirely and returning to what health insurance was initially intended to be, catastrophic medical care. If you get cancer a heart attack or are in a car crash then you get medical treatment. Anything else like an abortion or a sore throat, you pay for it out of your pocket.
If you had to pay for everyone to have their oil changed or tires rotated on their car then you would not be able to afford car insurance. Yet that is exactly what health insurance has become. Why should I have to pay because someone has autistic children and wants to get speech therapy ? Inappropriate and overuse of medical care is why insurance cost so much.