Basically, I just said it in the headline. But to elaborate:
The GOP Congress is at an impasse because it’s impossible to please both the Cro-Magnon wing of the party, which wants to make sure nobody gets healthcare from the gummint, and the moderate members, who know that their constituents don’t want to lose anything they’ve gained from Obamacare — such as providing coverage for people with pre-existing conditions.
For his part, Trump has promised that the replacement will be awesome, terrific, and nobody will lose out on anything.
And we know that the real problem with the ACA for Republicans is that it’s identified with Barack Obama. If you could somehow hypnotize every GOP voter into forgetting about the former president’s involvement, the whole repeal imperative would just fade away. They might not learn to love it, but they wouldn’t hate it the way they do.
And we know that the current president just loves putting his name on things, especially if they’re shiny, and isn’t particularly fussy about the facts as long as he gets credit.
So why not start calling the ACA “Trumpcare,” tell everybody “Obamacare” is gone, and have a party to celebrate?
You think this sounds stupid? What do call what the GOP has done on the issue so far? This approach is at least something doable…
The right strategy would have been to just wait. Wait and watch as Obamacare collapses under its own weight.
Today, the last insurance company in Iowa offering private insurance through Obamacare announced it will likely not offer policies next year. That’s going to happen across the country.
We’ll also start seeing the states that accepted the “free” Medicaid money start having to pay more and more (because the payments were set to kick in after Obama left office).
“State spending is projected to grow faster because starting next year, states must kick in 5 percent of the cost of patients who are newly eligible for Medicaid under the healthcare law’s expansion. Until now, the federal government has covered the total cost for those new enrollees. The federal share will further decline to 90 percent in 2020.”
It was all a bait-and-switch routine with Obama leading the scam. Once these delayed timebombs start going off, we’ll see Democrats crying for more money to be pumped into the failed system. That’s typical of government programs. Social Security and Medicare each have progressively increased their percentages for taxes since their inception.
What’s funny is that there is no leadership from Democrats on pushing for single payer. Why is that? Could it be that they are just as beholden to all the insurance companies, pharma companies, medical providers? Naw – that couldn’t be it. They just need a few little tweaks to the ironically named Affordable Care Act and we’ll all be swimming in a pool of free colonoscopies, unlimited opioids, and Viagra.
“What’s funny is that there is no leadership from Democrats on pushing for single payer.”
What’s funny about it? That is most assuredly NOT on the table. The Dems passed what they passed when they had control, now the Republicans are in charge. Do you think single payer has a chance NOW when it didn’t have a chance when Dems were running the show? How do you figure? The Democratic Party is a defeated army in disorganized retreat, trying not to lose any more than it’s already lost.
Of course, if I were in Congress, I’d be pushing for single payer. I’d have done it in 2009, I’d do it now, and I’d still be doing it in 2025. You know why? Because it’s the rational thing to do.
But I’ve been accused, many times, of being a guy who ignores political realities…
Doug, what you describe is the approach that Lindsey Graham described in an email today.
How come you and he are always on the same page? 🙂
Even a blind squirrel finds a nut every now and then. Even a blind neocon squirrel.
Lindsey Graham speaks until something sticks. He likely doesn’t even remember what he said in this e-mail. How this idiot keeps getting elected is beyond me. He tries so hard to be a powerful leader, when all he is is talk… if you can’t find Lindsey Graham in Washington, hold out a microphone and he’ll come running.
Actually, as I keep pointing out to Doug, the microphones go running to him, rather than the other way around.
And he’s the opposite of an idiot.
But wait: In defense of the second thing I said, I’ll contradict the first. I can think of one instance where I saw him go to the microphones, and he did it in an impressive way (this was early in his time in the Senate, when he wasn’t as famous and sought-after).
It was at the Republican National Convention in New York in 2004. I had asked for some time for an interview, and was invited instead to accompany him while he did a rapid-fire series of broadcast interviews at Madison Square Garden. First he went from table to table doing interviews with talk-radio types — somewhere between five and 10 of them, I seem to recall. He was poised and ready for anything, and handled each interview with ease, evidently enjoying the match of wits. It was like watching a chess master show off by playing a couple of dozen opponents at once.
Then we walked down to the TV area for more. In the hall we stopped so he could introduce me to Tim Russert and chat with him for awhile (someone who, not being a TV news watcher, I was then unfamiliar with).
At another point going down the hall, he took a call from Keven Cohen back home.
Finally, the fun part: In one of those network booths overlooking the floor of the Garden itself, he was interviewed by non other than Biff Henderson, David Letterman’s legendary camera guy.
Graham handled it all with ease — which is why today, the media people seek him out. He’s seldom a disappointing interview.
For my part, I got a column out of it…
Millions of people now have insurance that otherwise wouldn’t. A bit of tweaking would solve the problems that are exaggerated. Remember costs were spiraling before the ACA and people were being ruined health wise and financially. More winners than losers under ACA.
A bit of tweaking would require giving insurance companies billions of dollars more and increasing taxes on everyone to pay for Medicaid expansion.
Or just tax the rich. I know that’s your answer.
Otherwise known as taxing unearned income 🙂
Is unearned income now not taxed? I get oil and gas royalties… I get taxed on that income and I didn’t do anything to earn it except stay alive.
Tweaking, which could have been done starting in 2014 without Republican stonewalling, could contain cost containment (standardized claim forms, drug and device price negotiation, and expansion of low-cost practitioners, public clinics as an option), competition (a public option offered in counties with less than 3 insurers on an exchange), or fully-funded high-risk pool reimbursement. A one half % surtax on all net taxable income above $10,000 would certainly allow increasing the premium subsidies, and spread the cost broadly. The increasing no-insurance penalty will force more young and healthy hold-outs to support the system, but it has only started getting to the level to be felt in the pocketbook. Cutting the insurer overhead from 15% to 13% (that’s a lot of money) would force more fiscal discipline among insurers even as the program grows. It’s not simple, but it takes working together. Republicans want to sabotage the program, and have continually disguised their intentions.
So basically, Obama and Democrats missed the mark when designing Obamacare and conveniently allowed the pain to occur after he got reelected. What happened to those CBO scoring numbers that Democrats now claim are so accurate in predicting the future if Obamacare is repealed? They were wrong then and wrong now.
Dougs solution amounts to allowing people to die. That is the only way to keep the cost of healthcare down absent major government involvement. Free enterprise is not adequate in this particular industry. We had that type of system pre ACA. We spend waaay more than any other nation and with worse outcomes than most. The ACA is a good step forward to dealing with this.
I am now on the single payer bandwagon, bud. I don’t want Obamacare or Trumpcare. I want a tax on everyone.. poor or rich, same percentage, no cap. No more VA, Medicaid, or Medicare. One program. One tax. It will give us a base level of mediocre healthcare while the rich will continue to go to doctors who set up private services. There will be rationing of care and longer lines. There will be a ton of waste and fraud like any government program that lacks accountability. There will be battles over which drugs will be allowed.
All I would ask is that to save a lot of trouble, no money goes to abortions (let that be a state run program) and that no more advertising be allowed for prescription medicines.
I agree with that sentiment, but it would have to be phased-in.
They weren’t far wrong. The enrollment numbers are lower than they predicted, and premium rates rose slower than predicted. States allowed to opt out and deny Medicaid coverage (expansion) affected the numbers, but they were worlds more accurate than anybody else – because they were dedicated to accuracy, not ideology like right-oriented claims that were just wrong.
By the way, Obama said from day one the act would need modification as experience guided the way.
He also said from day one that “if you like your doctor, you can keep your doctor”. That’s as big a lie as any Trump has ever told.
Well, your mind is certainly made up, even to the point you can ignore my points about “tweaking” the law and serially obfuscate. It’s cool.
If it was a lie. Personally, I believe he thought it would end up that way. It would have been nuts to say that if he knew it wasn’t true, and unlike Trump, Obama is a careful man with both words and actions.
But it was a bad prediction to make, based on my long association with health care plans. Whenever there’s a change, there’s a good chance you’ll lose your preferred doctor…
Which was more grievous – “I will build a wall” or “You can keep your doctor?” There’s a better chance of the wall being built.
As for the tweaking, Harry, let’s see it happen. Where are the bills that call for the tweaks? If they are so obvious, surely a few Republicans would get onboard. Democrats have zero leadership. They are doing EXACTLY what Republicans did with Obama. Snipe, whine, and object.
“The increasing no-insurance penalty will force more young and healthy hold-outs to support the system…”
It’s a tax!
Okay. Got no problem with that.
I like the idea of single payer as long as people who don’t have money to buy food aren’t charged with tax evasion. The single payer insurance should cover needed preventive and medical care, including addiction recovery and psychiatric care. It should certainly cover women’s health including birth control and needed abortion (need to be decided by the woman and her doctor). I think that there should be an option for private insurance above and beyond the basic. If someone wants insurance against needing a tummy tuck or wrinkle remover it’s there. If one wants extra attention that insurance would cover that, too. You could even get extra insurance to cover the cost of Viagra if you wished.
Why is abortion SO important that it cannot be farmed out to health organizations that are funded either at the state level or by donations from those who support that cause? Are you willing to hang the entire healthcare system of the United States on that one procedure?
A flat tax on all income (including dividends) would eliminate the issue of buying food. There are options to get food stamps and other assistance. People have to understand that healthcare comes before pretty much everything else — tv, phone, sneakers, everything but food and shelter. Plus with a flat tax (call it Medicare Plus), when the tax needs to be raised, you can’t just target rich people. Everyone will know if the care they are receiving is worth the increase.
… and the very idea of covering Viagra is completely absurd. It should never be considered.
Doug, there are more people than you know who are working 2-3 jobs, at least 1 of which is full time to keep their families in food, clothing, and shelter. If you take that money in taxes out of the money they earn, they won’t have enough left for said basics. They’ll be on the streets. You want more homeless, especially more homeless women and children?
No, I’m not about to insist on covering abortion. If you want to reduce the need for abortion, and reduce the number of impoverished people, then contraceptives are a good idea. I will fight for keeping abortion legal, since I think making it illegal costs even more lives, but as long as poor women have access to better-than-coat-hanger-abortions, I’m not that concerned.
Brad, I mention Viagra only because I remember, all too well the insistence that insurance cover it.
I suppose there are some people who advocate for coverage of Viagra, but I don’t think the rest of us are obliged to go along with them….
“Doug, there are more people than you know who are working 2-3 jobs, at least 1 of which is full time to keep their families in food, clothing, and shelter. ”
No, there are not. It;s a very small percentage of American families. And the idea is you trade taxes for not having to pay copays, deductibles, etc. isn’t it? or are we sticking with that model as well which will allow the government to constantly tweak the prices upward? I’m working under the impression that single payer eliminates PAYING for services. If a provider still has to collect money, send out invoices, put people into collection, then this is not single payer. It’s just taxes.
So the few families that are working a couple jobs should see their cost of healthcare after taxes go to zero. One trip to the emergency room and they’re still going to be ahead of the game. Let’s say the tax is 6% of all income. A family making 30K a year would pay $1800 for unlimited healthcare with no restrictions. That’s about than the cost of a phone and basic cable plan.
And their net pay will likely qualify them for food stamps and housing assistance, right? The basic safety net will be in order. The challenge then is to have the initiative to climb out of the net.
“No, there are not. It;s a very small percentage of American families.”
Data from the Bureau of Labor Statistic show the majority of the people who live below the poverty level do not work, but this includes children, the elderly and the disabled poor. Among the poor between ages 18 and 64 who are not disabled or in school in 2014, 51.8 percent worked for part of the previous year.
I’m not stating an opinion; I prefer to deal in facts.
So what are the facts about families with someone working 2-3 jobs who are also poor? That’s what Karen referenced. How many working poor are working two jobs? How many are working three jobs?
Karen said it’s more than I think. I don’t think it’s that many. But if you show me the facts, I will gladly admit that I am wrong.
More facts that would help: how much are these people currently paying per year in out of pocket healthcare costs?
And, staying on my soapbox, I hope a reasonably intelligent person would know that working 2-3 jobs means you should not have kids. Sure, circumstances may put you in the position after they are born, but if you have kids when you know you can’t support them, you’re not much of a parent. But, don’t worry, someone else will cover for your irresponsibility.
Back in 98 or therabouts when Viagra first came out folks started demanding coverage, and most insurance companies complied. Then, when women noted that Viagra was covered, but no form of birth control was, they started demanding coverage in that department. It was only after much hoofarah that insurance companies started offering coverage for birth control.
Doug, you have no idea how difficult it is to “climb out” of poverty when you have 2 kids and you’re working 2 or 3 jobs just to keep food on the table. And when you finally get sick/injured to the point that you can’t work, you may well starve to death before any “safety net” kicks in.
So, did they advocate for Viagra coverage anonymously, or did guys come right out and say they needed it?
Which reminds me. I saw an ad recently for either Viagra or a competing product, and noticed something — the camera kept lingering on the woman, showing her pretty face in closeups a number of times, and there was a guy in the ad with her, but you could never quite see the guy’s face.
And I wondered: Did they want to be vague about the guy so that guys who are in the market for the product could imagine that that is THEM in the romantic situations with the pretty woman, or… could they not get an actor who would let his face be shown?
Probably the former…
“Did they want to be vague about the guy so that guys who are in the market for the product could imagine that that is THEM in the romantic situations…”
When they sell you a hamburger, they focus more on the burger than the guy eating it.
Well, Karen, as I said on another post, if you don’t climb down in the hole, you won’t have to climb out.
If you are poor, don’t have kids. Use the legal options available to prevent a lifetime of misery. Abortion, adoption, contraception, or just plain old common sense.
I don’t expect someone in that situation to fix themselves. Most have made choices that put them in that position. Now they just want the government to provide the bare minimum to keep them there.