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cthskzfn



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PostPosted: 03/07/17 12:55 pm    ::: GOP health care plan Reply Reply with quote

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-repeal-20170306-story.html


The proposal defunds Planned Parenthood. No federal funding can be made, either directly or indirectly, by Medicaid to a healthcare organization that “provides for abortions,” other than those done in cases of rape or incest or to save the life of the mother. That’s Planned Parenthood. It’s proper to note that Planned Parenthood doesn’t use federal funds to pay for abortions, as that’s already against the law. This measure shuts down funding for the organization just because it uses other funds to cover those procedures.

Income-based premium subsidies would be replaced by age-based subsidies, which will hurt working-class families in many states. Under the ACA, subsidies to help individual buyers afford premiums and (for poorer households) deductibles and co-pays were based on household income. The GOP measure will base them on the buyer’s age, instead, with older buyers receiving more help than younger. The GOP plan limits subsidies to $4,000 per individual; under the ACA, which also keys subsidies to the cost of benchmark insurance plans in the buyer’s home market, the subsidies theoretically could be several times higher. No family could receive more than $14,000 in subsidies, and no more than five family members could be eligible for subsidies.



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pilight



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PostPosted: 03/07/17 12:57 pm    ::: Reply Reply with quote

That's not what Trump campaigned on



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PostPosted: 03/07/17 1:58 pm    ::: Reply Reply with quote

pilight wrote:
That's not what Trump campaigned on



Laughing



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PostPosted: 03/07/17 7:31 pm    ::: Reply Reply with quote

So according to the experts this plan will increase the cost of insurance and will leave more people uninsured.

How is this "something better" than Obamacare?



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PostPosted: 03/07/17 11:55 pm    ::: Reply Reply with quote

Quote:
Physicians Health Plan’s CEO is reacting to the GOP’s proposed replacement of the Affordable Care Act.

“My guess is you’re going to see more choices and you’ll see some catastrophic plans that weren’t allowed before, which may be cheaper plans that someone younger may buy, but on the whole I think it’s going to be more expensive and I think it’s going to be tougher for those that need it to afford it,” Mike Cahill said.




http://wane.com/2017/03/07/php-ceo-weighs-in-on-gop-plan-to-replace-obamacare/



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PostPosted: 03/08/17 12:39 am    ::: Reply Reply with quote

If only there had been some clue ...


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PostPosted: 03/08/17 7:29 am    ::: Reply Reply with quote

my favorite part is the 6-pages it takes to define what happens if someone on Medicaid wins the lottery!!! Shocked Shocked Rolling Eyes Rolling Eyes



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PostPosted: 03/14/17 3:31 pm    ::: Reply Reply with quote

24 million more uninsured according to the CBO, and 26 million according to Trump's own internal numbers.

The GOP "plan" is not a healthcare plan, it is a deficit reduction plan at the expense of the poor and elderly. It is also a hot, steaming pile of dog shit.

And why is it that the GOP can't come up with a true "free market" healthcare plan that offers comprehensive care, no artificial caps, keeps prices down and has universal coverage? Because that is exactly what Obamacare was supposed to be. No free market plan is going to do it better.

This sums it up beautifully: https://mobile.nytimes.com/2017/03/14/opinion/the-original-lie-about-obamacare.html

Quote:
The reason is simple enough: Obamacare is the bipartisan version of health reform. It accomplishes a liberal end through conservative means and is much closer to the plan conservatives favored a few decades ago than the one liberals did. “It was the ultimate troll,” as Michael Anne Kyle of Harvard Business School put it, “for Obama to pass Republican health reform.”



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PostPosted: 03/14/17 6:56 pm    ::: Reply Reply with quote

justintyme wrote:
24 million more uninsured according to the CBO, and 26 million according to Trump's own internal numbers.

The GOP "plan" is not a healthcare plan, it is a deficit reduction plan at the expense of the poor and elderly. It is also a hot, steaming pile of dog shit.

And why is it that the GOP can't come up with a true "free market" healthcare plan that offers comprehensive care, no artificial caps, keeps prices down and has universal coverage? Because that is exactly what Obamacare was supposed to be. No free market plan is going to do it better.

This sums it up beautifully: https://mobile.nytimes.com/2017/03/14/opinion/the-original-lie-about-obamacare.html

Quote:
The reason is simple enough: Obamacare is the bipartisan version of health reform. It accomplishes a liberal end through conservative means and is much closer to the plan conservatives favored a few decades ago than the one liberals did. “It was the ultimate troll,” as Michael Anne Kyle of Harvard Business School put it, “for Obama to pass Republican health reform.”


24 million is significantly more than gained coverage via Obamacare. That means the Republicans explicitly want to make health care worse than it prior to 2009.


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PostPosted: 03/14/17 7:53 pm    ::: Reply Reply with quote

Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked



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pilight



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PostPosted: 03/14/17 8:00 pm    ::: Reply Reply with quote

Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.



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PostPosted: 03/15/17 4:40 pm    ::: Reply Reply with quote

pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.



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cthskzfn



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PostPosted: 03/15/17 4:52 pm    ::: Reply Reply with quote

Democrats said otherwise in 12/14:

Contrary to Republican claims, the process that led to the passage of the Affordable Care Act was one of the most transparent in our nation's history. Below is a selection of points to refute many claims House Republicans are expected to make at today's hearing.

FACT: The ACA had a historic number of hours of debate and amendments during Committee development of the legislations.

The House process spanned three committees - Energy and Commerce, Ways and means, and Education and Labor - with dozens of hearings over many months.
Specifically, the House held 79 bipartisan hearings and markups on the health reform bill over the period of an entire year.
House members spent nearly 100 hours in hearings, heard from 181 witnesses from both sides of the aisle, considered 239 amendments (both Democratic and Republican), and accepted 121 amendments.
FACT: The Senate held dozens of public meetings and hearings in both the Finance and HELP Committees and accepted hundreds of Republican amendments.

The HELP Committee held 14 bipartisan roundtables, 13 bipartisan hearings, and 20 bipartisan walkthroughs on health reform.
The HELP Committee considered nearly 300 amendments and accepted more than 160 Republican amendments.
The Finance Committee held 17 roundtables, summits, and hearings on health reform. The Finance Committee also held 13 member meetings and walkthroughs and 38 meetings and negotiations for a total of 53 meetings on health reform. [Senate Finance Committee, 5/3/10]
The Finance Committee held a seven-day markup of the bill, the longest Finance Committee markup in 22 years, resulting in a bipartisan 14-to-9 vote to approve the bill. [Senate Finance Committee, 5/3/10]
The Finance Committee markup resulted in 41 amendments to revise the bill, including 18 by unanimous consent or without objection. [Senate Finance Committee, 10/13/09]
FACT: The financing of the ACA's coverage provisions was well known and debated.

When the bill came to the floor, the Senate spent 25 consecutive days in session on health reform, the second longest consecutive session in history. In total, the Senate spent more than 160 hours considering the health reform legislation.

The non-partisan Congressional Budget Office issued many reports on the Affordable Care Act's financing, clearly showing that revenue would be raised by the personal responsibility provision, also known at the individual mandate or free-rider penalty, in every case that it described the law's coverage provisions. [CBO, 12/10; The Washington Post, 9/24/14; ASPE, 9/24/14]
CBO also wrote extensively about how a properly-functioning insurance market would work as designed under the ACA. The entire purpose of insurance is to balance out the risk of healthy and non-healthy enrollees; anyone who believes that this point was avoided during debate of the ACA was simply not paying attention to advocates of the law as they described it during the many public hearings the law received.


https://www.dpcc.senate.gov/?p=issue&id=328




The GOP is trying to ram it through because it's passage would mean a major tax cut for the super wealthy, increased profits for ins. co.s via shit coverage for many Americans, including many poor whites who voted for Trump because they hate the ACA because a black man advocated it and are ignorant to the fact that Rubio killed the risk corridors 2 yrs ago which resulted in policy premium increases.

Move on, nothing to see....



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PostPosted: 03/15/17 4:59 pm    ::: Reply Reply with quote

Howee wrote:
pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.


I'm generally against rushing legislation, especially when there's no particular time pressure involved.

The ACA has been good for some people and bad for others, like most government programs. I had insurance before the ACA and now I don't, because I can't afford it. Unfortunately, I make too much money to qualify for subsidies but not enough to actually purchase insurance at the higher rates now being charged. Premium rates and deductibles have skyrocketed, which is why the ACA has so many people opposed to it.

The GOP plan is a bad joke, and a move directly away from what Trump campaigned on.



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PostPosted: 03/15/17 5:33 pm    ::: Reply Reply with quote

pilight wrote:
Howee wrote:
pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.


I'm generally against rushing legislation, especially when there's no particular time pressure involved.

The ACA has been good for some people and bad for others, like most government programs. I had insurance before the ACA and now I don't, because I can't afford it. Unfortunately, I make too much money to qualify for subsidies but not enough to actually purchase insurance at the higher rates now being charged. Premium rates and deductibles have skyrocketed, which is why the ACA has so many people opposed to it.

The GOP plan is a bad joke, and a move directly away from what Trump campaigned on.

The biggest problem is that they were never willing to tweak the program. The structure of the ACA is just fine, but not enough healthy people signed up and chose to pay the fine instead. Had they auto enrolled, it would have kept the prices down dramatically. The second problem came when the GOP defunded the risk corridors. Originally, the government was going to subsidize insurance companies that took on high risk individuals. since this didn't happen, this lead to higher premiums.

These are all fixes that would have been simple to make if both parties of congress were committed to making the ACA work. But unfortunately, there are those who don't see comprehensive health coverage as a basic human right, and instead see it as something to have if you can afford it.



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PostPosted: 03/15/17 6:27 pm    ::: Reply Reply with quote

pilight wrote:
Howee wrote:
pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.


I'm generally against rushing legislation, especially when there's no particular time pressure involved.

The ACA has been good for some people and bad for others, like most government programs. I had insurance before the ACA and now I don't, because I can't afford it. Unfortunately, I make too much money to qualify for subsidies but not enough to actually purchase insurance at the higher rates now being charged. Premium rates and deductibles have skyrocketed, which is why the ACA has so many people opposed to it.

The GOP plan is a bad joke, and a move directly away from what Trump campaigned on.




Thank Rubio and the GOP for that. By killing the risk corridors they GUARANTEED PREMIUM HIKES.

I wonder how many of the Obamacare-hating Trump voters know this.



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PostPosted: 03/15/17 7:00 pm    ::: Reply Reply with quote

cthskzfn wrote:
pilight wrote:
Howee wrote:
pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.


I'm generally against rushing legislation, especially when there's no particular time pressure involved.

The ACA has been good for some people and bad for others, like most government programs. I had insurance before the ACA and now I don't, because I can't afford it. Unfortunately, I make too much money to qualify for subsidies but not enough to actually purchase insurance at the higher rates now being charged. Premium rates and deductibles have skyrocketed, which is why the ACA has so many people opposed to it.

The GOP plan is a bad joke, and a move directly away from what Trump campaigned on.




Thank Rubio and the GOP for that. By killing the risk corridors they GUARANTEED PREMIUM HIKES.

I wonder how many of the Obamacare-hating Trump voters know this.


That didn't happen until 2015. Premiums and deductibles were way up before that.



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PostPosted: 03/15/17 7:25 pm    ::: Reply Reply with quote

Opponents always run ads about "my premiums went up X%". But they were going up rapidly, often by double digits annually, without Obamacare. And companies were already cancelling plans and coverages for certain pools or in certain states.

Nobody ever seems to discuss whether the increases or cancellations are more or less than they would have been without the law. Have they accelerated or decelerated?

Talking about increases or cancellations in isolation is completely meaningless.


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PostPosted: 03/15/17 8:10 pm    ::: Reply Reply with quote

.....AND.... please explain why this "reform" necessarily entails a tax CUT for the wealthiest? Is there some inherent connection that's unavoidable, or just another (unspoken) Trump promise he's fulfilling?



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PostPosted: 03/15/17 9:35 pm    ::: Reply Reply with quote

Howee wrote:
.....AND.... please explain why this "reform" necessarily entails a tax CUT for the wealthiest? Is there some inherent connection that's unavoidable, or just another (unspoken) Trump promise he's fulfilling?


I think the way that's being characterized is a little misleading.

If I'm not mistaken, I think what they are referring to is the elimination of the mandatory universal coverage penalty, which is treated as a tax for various legal reasons.

Because the penalty for people who don't buy insurance is 2.5% of total household adjusted gross income to a maximum of $2,085, families of four making about $80,000 in AGI or more get the full $2000 so called "tax cut" by the elimination of the penalty, while people making less were paying a smaller penalty and thus get a smaller reduction when the penalty is eliminated.

Obama said it wasn't a tax when he was trying to get it passed so he could say there were no new taxes, until they got into court over the Constitutionality of the ACA where it was preferable legally to say it was a tax. But it's not a "tax cut" in the sense anyone would normally consider a tax cut.

Most people aren't paying the penalty anyhow so it's irrelevant to everyone except those who are paying the penalty rather than buy insurance. But yes, technically, of that small universe, the people paying the max because of their income and family size get a bigger "cut" than those making less and paying less than the max penalty.

Of all the crap in the Ryan plan, this to me is a total non issue. The big issue is that if you eliminate the coercion for everyone to have insurance, the whole system collapses from an actuarial standpoint. Any rational healthcare system has to have near or complete universal coverage or adverse selection will make the costs of insurance prohibitive. The Ryan plan "buy in" penalty is a disaster in concept. That's the real issue, not that some people get a bigger "cut" than others.


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PostPosted: 03/16/17 1:41 am    ::: Reply Reply with quote

ArtBest23 wrote:
[
I think the way that's being characterized is a little misleading.

If I'm not mistaken, I think what they are referring to is the elimination of the mandatory universal coverage penalty, which is treated as a tax for various legal reasons.

The tax cut is the removal of the 3.8% surtax on investment income and the .9% medicare tax, both which were on income over 250k/year.



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PostPosted: 03/16/17 9:49 am    ::: Reply Reply with quote

justintyme wrote:
ArtBest23 wrote:
[
I think the way that's being characterized is a little misleading.

If I'm not mistaken, I think what they are referring to is the elimination of the mandatory universal coverage penalty, which is treated as a tax for various legal reasons.

The tax cut is the removal of the 3.8% surtax on investment income and the .9% medicare tax, both which were on income over 250k/year.



^^^^^^^^^^^^^^^^^^^^



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PostPosted: 03/16/17 9:50 am    ::: Reply Reply with quote

[quote="pilight"]
cthskzfn wrote:
pilight wrote:
Howee wrote:
pilight wrote:
Howee wrote:
Anybody here have better insight on WHY the biggest GOP proponents of the new legislation (e.g., Ryan) feel the need to rush this through? That makes it rather dubious, imo, i.e., "NOTHINGTOSEEHEREJUSTVOTE.QUICK!" Shocked


They always want to rush when people are paying attention. Democrats did the same thing.


Well, I see your point, but....wouldn't some combination of intelligence and common sense demand that your point serve as a cautionary tale?? IFF the GOP touts the ACA to be such a reprehensible, damnable cause for public alarm and hysteria....then WHY would they repeat its 'errors' of hasty/incomplete formulation and legislation?

I have no doubt you've viewed both positions with more scrutiny than I have: what's your take on the comparative benefits/disadvantages?

I for one am GLAD for the coverage I've been afforded under ACA. When I first applied, not so much. Now, its been invaluable to me.


I'm generally against rushing legislation, especially when there's no particular time pressure involved.

The ACA has been good for some people and bad for others, like most government programs. I had insurance before the ACA and now I don't, because I can't afford it. Unfortunately, I make too much money to qualify for subsidies but not enough to actually purchase insurance at the higher rates now being charged. Premium rates and deductibles have skyrocketed, which is why the ACA has so many people opposed to it.

The GOP plan is a bad joke, and a move directly away from what Trump campaigned on.




Thank Rubio and the GOP for that. By killing the risk corridors they GUARANTEED PREMIUM HIKES.

I wonder how many of the Obamacare-hating Trump voters know this.


That didn't happen until 2015. Premiums and deductibles were way up before that.[/quote




As Artbest says, rate of increase is the issue, and why, ultimately, single-payer is the only answer.



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PostPosted: 03/16/17 12:24 pm    ::: Reply Reply with quote

cthskzfn wrote:



As Artbest says, rate of increase is the issue, and why, ultimately, single-payer is the only answer.


I certainly don't agree single payer is the only economic approach, and it will never be accepted by the public in this country. It is counterproductive to true healthcare reform for the Dems to continue to push it. It is too easy for opponents to paint every Dem plan as just a means of getting to single payer.

What is critical is mandatory universalcoverage. The economics won't work unless the pool includes the entire population, including people who are currently healthy.

We should have a national plan modeled after the FEHBA. Government sets minimum coverage, companies compete with a variety of plans. Basic plans, richer plans, hmos, etc. As long as there is universal coverage, and possibly an adverse selection pool like in FEHBA, it works.

It really isn't that hard. Obama and Pelosi blew the one opportunity. Obama instead of leading turned it over to Congressional Dems, and Congressional Dems had a wish list of crap they cared about more than fixing the health insurance system. Obamacare is a mess, and it's not going to get fixed anytime soon.

So we're doomed to stumble from one politicized patch to the next while costs continue to cripple the economy and a lot of people.


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PostPosted: 03/16/17 1:14 pm    ::: Reply Reply with quote

ArtBest23 wrote:

I certainly don't agree single payer is the only economic approach, and it will never be accepted by the public in this country. It is counterproductive to true healthcare reform for the Dems to continue to push it. It is too easy for opponents to paint every Dem plan as just a means of getting to single payer.

I am not so sure about that. While I agree based on the current status quo that it is unlikely to happen, my prediction is that if the GOP continues to do what they are doing and either cuts Obamacare without replacement, refuses to fix it so that it implodes, or replaces it with the type of crap that they are offering (ie: not universal, comprehensive coverage), within a decade we will be on a single payer system. Why? Because the ACA is the basic framework which offers a market based system to achieve universal coverage. There are tweaks that can make it better and actually universal if both sides are willing to commit to it, but outside of that frame work I don't know of an actual market solution (mostly because health care is nore of a public service than it is a market commodity, and thus "free markets" will never achieve that goal alone without major government involvement).

So, when the uninsured numbers skyrocket, and the more liberal millennials and generation z become the major voting forces, the demand for a fix will be deafening. And the simplest solution (not necessarily the best, but the simplest to explain and understand) to achieve universal coverage is single payer.

The vast majority right now sees affordable, quality health care as a right. In 10 years this will be even more pronounced. If the GOP sticks to outdated ideology, they will lose all of their ground and will end up with something even more "socialist" than the absolutely non-socialist ACA. While they scored short term political points by abandoning the ACA and demonizing it, that position is going to have terrible long term political costs for them.


Quote:

What is critical is mandatory universalcoverage. The economics won't work unless the pool includes the entire population, including people who are currently healthy.

We should have a national plan modeled after the FEHBA. Government sets minimum coverage, companies compete with a variety of plans. Basic plans, richer plans, hmos, etc. As long as there is universal coverage, and possibly an adverse selection pool like in FEHBA, it works.


Honestly, they should take a long hard look at Germany's system, which is basically a working version of the principles behind the ACA.



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PostPosted: 03/16/17 1:53 pm    ::: Reply Reply with quote

justintyme wrote:
the ACA is the basic framework which offers a market based system to achieve universal coverage. There are tweaks that can make it better and actually universal if both sides are willing to commit to it, but outside of that frame work I don't know of an actual market solution (mostly because health care is nore of a public service than it is a market commodity, and thus "free markets" will never achieve that goal alone without major government involvement).


I completely disagree with all of this.

The ACA isn't a decent framework for anything. It's a cribbed together mess by people who didn't believe in what they were doing and actually just wanted a huge government social program. It's a mess and a bad joke and was doomed to be an expensive, unsatisfactory mess, which it is.

The starting problem in your response is failing to acknowledge that delivery of health care and payment for health care are two different things.

Health insurance is certainly not a "public service" and most definitely is amenable to market solutions based on sound actuarial principals just like every other type of insurance.

The delivery of healthcare services is a separate issue that requires some degree of regulation, as it always has.

It's just not that difficult if you let the experts instead of the politicians design it.

You want to see what a mess a single payer government system looks like? There is no more wasteful, inefficient, expensive system, than the Tricare program.


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PostPosted: 03/16/17 2:30 pm    ::: Reply Reply with quote

ArtBest23 wrote:
The starting problem in your response is failing to acknowledge that delivery of health care and payment for health care are two different things.

Health insurance is certainly not a "public service" and most definitely is amenable to market solutions based on sound actuarial principals just like every other type of insurance.


Not really. Health insurance is all about risk. In order to keep premiums down the insurance companies either need to be able to cap what pay out, exclude people that pose to much risk for them (or else be able to charge them insane amounts like auto "risk" insurance), and simply deny coverage to people that will cost them too much money (pre-existing conditions). If the government is going to stop them from being able to do these things it is going to raise the costs for everyone, because the market demand for this insurance will always be significantly higher from people who feel they are at risk. Healthy people, when left to their own devices will mostly opt to do without.

The first way you counter this is by the government forcing low risk people to also purchase insurance to balance out the demand from high risk. Thus you have the individual mandate.

The second way is to offer risk corridors in which the government compensates insurers for taking on high risk individuals.

This is the basic principle behind the ACA.

But I am confused on how you think we achieve universal health care without universal insurance coverage? Left to its own devices, a free market healthcare system would only provide its service to what people could afford. It would prioritize the wealthy and give better service to those who can pay for it.

The answer to this is government mandated equitable service from health care providers. But if you mandate this, you need to be able to make sure the providers are compensated, which is where insurance becomes a factor.

The way our healthcate system works, if we want to ensure that everyone has full access to comprehensive, quality healthcare we need to make sure everyone has access to affordable comprehensive health insurance. Otherwise seeing a doctor, having non life or death surgery, preventative care, and managing cetain chronic conditions becomes a financial decision rather than a health decision and that is what needs to be stopped.



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PostPosted: 03/16/17 3:19 pm    ::: Reply Reply with quote

justintyme wrote:

Not really. Health insurance is all about risk. In order to keep premiums down the insurance companies either need to be able to cap what pay out, exclude people that pose to much risk for them (or else be able to charge them insane amounts like auto "risk" insurance), and simply deny coverage to people that will cost them too much money (pre-existing conditions). If the government is going to stop them from being able to do these things it is going to raise the costs for everyone, because the market demand for this insurance will always be significantly higher from people who feel they are at risk. Healthy people, when left to their own devices will mostly opt to do without.

The first way you counter this is by the government forcing low risk people to also purchase insurance to balance out the demand from high risk. Thus you have the individual mandate.

The second way is to offer risk corridors in which the government compensates insurers for taking on high risk individuals.

This is the basic principle behind the ACA.

But I am confused on how you think we achieve universal health care without universal insurance coverage? Left to its own devices, a free market healthcare system would only provide its service to what people could afford. It would prioritize the wealthy and give better service to those who can pay for it.

The answer to this is government mandated equitable service from health care providers. But if you mandate this, you need to be able to make sure the providers are compensated, which is where insurance becomes a factor.

The way our healthcate system works, if we want to ensure that everyone has full access to comprehensive, quality healthcare we need to make sure everyone has access to affordable comprehensive health insurance. Otherwise seeing a doctor, having non life or death surgery, preventative care, and managing cetain chronic conditions becomes a financial decision rather than a health decision and that is what needs to be stopped.


You're missing so much of the picture regarding management of utilization. This is why they need the pros because lay people and politicians just don't understand.

And the reason they're separate is because anyone is free to get any care from any doctor they choose. They just can't always expect someone else to pay for it. No different than saying anyone can buy any car, but not everyone can afford any car.

Basic healthcare should be available to all. That doesn't mean everyone is entitled to Cadillac health care. Everyone's entitled to food and clothing too, but that doesn't mean everyone's entitled to lobster and Jimmy Choo shoes. Everyone should get cancer treatment, but maybe everyone can't get a private room at Mayo.

You know, everyone pays the same thing for each of the 100+ plans provided by the FEHBA program regardless of age, sex, health or other actuarial factors. There are no "risk corridors" or other rubbish. Yet there are no shortage of companies eager to participate.

The left wants to pretend it's far more complicated than it is as their excuse for saying creating the world's biggest social welfare program and government control of peoples' lives is the only choice. It's bullshit.


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PostPosted: 03/16/17 4:04 pm    ::: Reply Reply with quote

ArtBest23 wrote:

Basic healthcare should be available to all. That doesn't mean everyone is entitled to Cadillac health care. Everyone's entitled to food and clothing too, but that doesn't mean everyone's entitled to lobster and Jimmy Choo shoes. Everyone should get cancer treatment, but maybe everyone can't get a private room at Mayo.

People should be entitled to what their health dictates they need. If their health issue requires a Mayo specialist, then they should have access to it. I doubt health would dictate the need of a "private room".

Not everyone should be entitled to a Cadillac, but they definitely are entited to a car with brakes, airbag, and the like.



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PostPosted: 03/16/17 4:18 pm    ::: Reply Reply with quote

justintyme wrote:
ArtBest23 wrote:

Basic healthcare should be available to all. That doesn't mean everyone is entitled to Cadillac health care. Everyone's entitled to food and clothing too, but that doesn't mean everyone's entitled to lobster and Jimmy Choo shoes. Everyone should get cancer treatment, but maybe everyone can't get a private room at Mayo.

People should be entitled to what their health dictates they need. If their health issue requires a Mayo specialist, then they should have access to it. I doubt health would dictate the need of a "private room".

Not everyone should be entitled to a Cadillac, but they definitely are entited to a car with brakes, airbag, and the like.


No, everyone is NOT "entitled" to the #1 specialist in the world for whatever ails them. That's absurd dreamland stuff.

Everyone should receive mainstream, medically accepted course of treatment by competent and qualified health care personnel.

If they want more than that, they can pay for it themselves. Just like they can buy their own Jimmy Choos.


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PostPosted: 03/16/17 4:27 pm    ::: Reply Reply with quote

ArtBest23 wrote:

No, everyone is NOT "entitled" to the #1 specialist in the world for whatever ails them. That's absurd dreamland stuff.

Everyone should receive mainstream, medically accepted course of treatment by competent and qualified health care personnel.

If they want more than that, they can pay for it themselves. Just like they can buy their own Jimmy Choos.

Then this is where we fundementally disagree. Rich and poor alike have the same value to their lives. If someone's condition cannot be adequately treated by the local doctor and they require a specialist to tackle their extremely rare form of cancer, or incredibly complicated heart condition, then they should have access to that person. It should be the health needs of the individual to see that specialist, not the individual's wealth.



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PostPosted: 03/16/17 4:45 pm    ::: Reply Reply with quote

justintyme wrote:
ArtBest23 wrote:

No, everyone is NOT "entitled" to the #1 specialist in the world for whatever ails them. That's absurd dreamland stuff.

Everyone should receive mainstream, medically accepted course of treatment by competent and qualified health care personnel.

If they want more than that, they can pay for it themselves. Just like they can buy their own Jimmy Choos.

Then this is where we fundementally disagree. Rich and poor alike have the same value to their lives. If someone's condition cannot be adequately treated by the local doctor and they require a specialist to tackle their extremely rare form of cancer, or incredibly complicated heart condition, then they should have access to that person. It should be the health needs of the individual to see that specialist, not the individual's wealth.


A specialist doesn't mean "world renowned specialist".

Just because you need an orthopedist doesn't mean insurance needs to pay for you to be treated by Dr James Andrews.

If you need to mischaracterize what I said in order to make your argument work, maybe it's because your position is indefensible.


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PostPosted: 03/16/17 4:47 pm    ::: Reply Reply with quote

ArtBest23 wrote:
justintyme wrote:
the ACA is the basic framework which offers a market based system to achieve universal coverage. There are tweaks that can make it better and actually universal if both sides are willing to commit to it, but outside of that frame work I don't know of an actual market solution (mostly because health care is nore of a public service than it is a market commodity, and thus "free markets" will never achieve that goal alone without major government involvement).


I completely disagree with all of this.

The ACA isn't a decent framework for anything. It's a cribbed together mess by people who didn't believe in what they were doing and actually just wanted a huge government social program. It's a mess and a bad joke and was doomed to be an expensive, unsatisfactory mess, which it is.

The starting problem in your response is failing to acknowledge that delivery of health care and payment for health care are two different things.

Health insurance is certainly not a "public service" and most definitely is amenable to market solutions based on sound actuarial principals just like every other type of insurance.

The delivery of healthcare services is a separate issue that requires some degree of regulation, as it always has.

It's just not that difficult if you let the experts instead of the politicians design it.

You want to see what a mess a single payer government system looks like? There is no more wasteful, inefficient, expensive system, than the Tricare program.



A one page bill: The age requirement for Medicare is birth.

Medicare for all.



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PostPosted: 03/16/17 5:02 pm    ::: Reply Reply with quote

ArtBest23 wrote:
justintyme wrote:
ArtBest23 wrote:

No, everyone is NOT "entitled" to the #1 specialist in the world for whatever ails them. That's absurd dreamland stuff.

Everyone should receive mainstream, medically accepted course of treatment by competent and qualified health care personnel.

If they want more than that, they can pay for it themselves. Just like they can buy their own Jimmy Choos.

Then this is where we fundementally disagree. Rich and poor alike have the same value to their lives. If someone's condition cannot be adequately treated by the local doctor and they require a specialist to tackle their extremely rare form of cancer, or incredibly complicated heart condition, then they should have access to that person. It should be the health needs of the individual to see that specialist, not the individual's wealth.


A specialist doesn't mean "world renowned specialist".

Just because you need an orthopedist doesn't mean insurance needs to pay for you to be treated by Dr James Andrews.

If you need to mischaracterize what I said in order to make your argument work, maybe it's because your position is indefensible.

Except that I have never argued to that specific of a case. Itam only saying that health should dictate, not finances. If a local doctor or a local specialist can take care of your health issue there is no reason to go to the #1 doctor. If your case can only be solved by that #1 doctor than you should have the ability to see that doctor. That is as far as I am going with my argument. Which is actually the way that the Mayo currently takes on clients.



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ArtBest23



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PostPosted: 03/16/17 5:43 pm    ::: Reply Reply with quote

cthskzfn wrote:
ArtBest23 wrote:
justintyme wrote:
the ACA is the basic framework which offers a market based system to achieve universal coverage. There are tweaks that can make it better and actually universal if both sides are willing to commit to it, but outside of that frame work I don't know of an actual market solution (mostly because health care is nore of a public service than it is a market commodity, and thus "free markets" will never achieve that goal alone without major government involvement).


I completely disagree with all of this.

The ACA isn't a decent framework for anything. It's a cribbed together mess by people who didn't believe in what they were doing and actually just wanted a huge government social program. It's a mess and a bad joke and was doomed to be an expensive, unsatisfactory mess, which it is.

The starting problem in your response is failing to acknowledge that delivery of health care and payment for health care are two different things.

Health insurance is certainly not a "public service" and most definitely is amenable to market solutions based on sound actuarial principals just like every other type of insurance.

The delivery of healthcare services is a separate issue that requires some degree of regulation, as it always has.

It's just not that difficult if you let the experts instead of the politicians design it.

You want to see what a mess a single payer government system looks like? There is no more wasteful, inefficient, expensive system, than the Tricare program.



A one page bill: The age requirement for Medicare is birth.

Medicare for all.


You left out line three.

Every morning the Secretary of the Treasury will pick the necessary dollars off the money tree growing on the White House South lawn. If on any morning there aren't enough ripe dollars on the money tree, the Secretary will gather an egg from the Golden Goose.


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PostPosted: 03/16/17 6:47 pm    ::: Reply Reply with quote

Single payer has its issues, but one of them is not government expense. Empirically, costs come down and because it gets paid out of payroll taxes everyone is included in the risk pool. No longer is the government paying to subsidize which eliminates the need for Medicaid spending and it basically collects its premiums from the public. For the most part people just pay what they would have to a private insurer to the government instead. With the elimination of much of the administration costs and the ability to dictate prices, people actually pay less in the long run. It also eliminates administration costs of businesses, especially medium sized businesses, by getting them out of the health insurance game.



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PostPosted: 03/16/17 7:04 pm    ::: Reply Reply with quote

justintyme wrote:
No longer is the government paying to subsidize which eliminates the need for Medicaid spending and it basically collects its premiums from the public. For the most part people just pay what they would have to a private insurer to the government instead. With the elimination of much of the administration costs and the ability to dictate prices, people actually pay less in the long run. It also eliminates administration costs of businesses, especially medium sized businesses, by getting them out of the health insurance game.


No subsidies. Really? So you're not planning on covering un- or under-employed? Interesting.

Eliminates much of the administrative costs - Really? Because government run programs like Medicare, Medicaid, VA, are so efficient and devoid of waste and fraud. Gee I must have forgotten that.

I guarantee you it will cost the government at least double what it costs private industry to provide the same care.


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PostPosted: 03/16/17 7:51 pm    ::: Reply Reply with quote

ArtBest23 wrote:
justintyme wrote:
No longer is the government paying to subsidize which eliminates the need for Medicaid spending and it basically collects its premiums from the public. For the most part people just pay what they would have to a private insurer to the government instead. With the elimination of much of the administration costs and the ability to dictate prices, people actually pay less in the long run. It also eliminates administration costs of businesses, especially medium sized businesses, by getting them out of the health insurance game.


No subsidies. Really? So you're not planning on covering un- or under-employed? Interesting.

Eliminates much of the administrative costs - Really? Because government run programs like Medicare, Medicaid, VA, are so efficient and devoid of waste and fraud. Gee I must have forgotten that.

I guarantee you it will cost the government at least double what it costs private industry to provide the same care.

Then why is it much more efficient in every other country that has it?

There will be waste and fraud, but there is in the current system as well. But you get rid of advertising, executive pay and other labor costs, redundant positions, sales people, etc. And the government struggles with half in and half out programs. Going all in on healthcare would actually help programs like the VA.

As far as subsidies, it would be the government paying itself. In other words there would be no increase in cost from what they currently pay out in healthcare. Yet they would take in more money since it will not be paid out to insurance companies by the people, but be paid to the gov.



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PostPosted: 03/16/17 9:13 pm    ::: Reply Reply with quote

It's the Democrats' wet dream. The biggest, most expensive, most wasteful, most bureaucratic, most intrusive social welfare program in the history of mankind.

Hundreds of thousands of government jobs. Hundreds of billions of dollars in new taxes and new debt. A massive government database of every personal detail about every single American. And once created and with its tenacles deeply imbedded into every person in the country, no way to ever undo it. Every American completely dependant on the Government for their very survival. And no one with any personal choice or control.

It would be the destruction of the America that two hundred years of Americans intended to exist.

I'm not some nutjob right wing zealot and even I can see this for the disaster it would be.


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PostPosted: 03/16/17 9:52 pm    ::: Reply Reply with quote

Why would the US face something that no other country has faced? This is not what has happened elsewhere. Lower costs, more people covered. I don't know why it is assumed that it would be different here. The track record is just about universally positive.



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PostPosted: 03/16/17 11:24 pm    ::: Reply Reply with quote

I have always conceded my inability to comprehend the complex economics of something like this, but....like Justin....I look to the examples of countries where single payer operates just fine. I have 20+ Canadian friends (with various health concerns) who vouch for that. They can't all be mistaken. I only know one German, who says their system is great.

Yes, we have many more citizens than either one of those places, but....we're also a wealthier nation than either, no? Why can't the model operate here, too?



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PostPosted: 03/17/17 12:52 am    ::: Reply Reply with quote

To be fair, the German system is not actually true single payer. There are about 200 odd insurance companies that compete, though they are all heavily regulated (no deductibles or copays allowed). They also auto enroll all their citizens in a predetermined plan if they fail to find one themselves. But the premiums are paid to the government by a straight 8% tax on everyone, who then pays the insurers based on the number they cover.

http://m.startribune.com/want-a-new-health-care-model-the-germans-do-it-right/411702466/

IMO, it was the ACA principles done right.



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PostPosted: 03/17/17 7:09 am    ::: Reply Reply with quote

FWIW, at least one prominent Republican agrees with Justintyme...

http://www.advocate.com/election/2015/9/28/read-donald-trumps-advocate-interview-where-he-defends-gays-mexicans

Donald Trump wrote:
I would press for universal health care. It’s ridiculous that the richest country on Earth can’t provide first-rate health care for our people. I would put forward a comprehensive health care program and fund it with an increase in corporate taxes. I’d strictly regulate the pharmaceutical firms to end these 500% profits on drugs that are cheap to produce. I like the Canadian system, although their health care is not the best. If you combine their system with the quality of our health care, we could provide cradle-to-grave health care for everyone.



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PostPosted: 03/17/17 11:01 am    ::: Reply Reply with quote

justintyme wrote:
Why would the US face something that no other country has faced? This is not what has happened elsewhere. Lower costs, more people covered. I don't know why it is assumed that it would be different here. The track record is just about universally positive.


I always love it when people say "well X program seems to work in a much smaller, more homogenous country with an entirely different history regarding the structure, utilization, expectations, and costs of healthcare, so why wouldn't the same thing automatically work here? "

Ohhhhhhh, I don't know. . . . .


ArtBest23



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PostPosted: 03/17/17 11:05 am    ::: Reply Reply with quote

pilight wrote:
FWIW, at least one prominent Republican agrees with Justintyme...

http://www.advocate.com/election/2015/9/28/read-donald-trumps-advocate-interview-where-he-defends-gays-mexicans

Donald Trump wrote:
I would press for universal health care. It’s ridiculous that the richest country on Earth can’t provide first-rate health care for our people. I would put forward a comprehensive health care program and fund it with an increase in corporate taxes. I’d strictly regulate the pharmaceutical firms to end these 500% profits on drugs that are cheap to produce. I like the Canadian system, although their health care is not the best. If you combine their system with the quality of our health care, we could provide cradle-to-grave health care for everyone.


And I don't think anyone here is questioning universal healthcare.

That doesn't remotely mean single payer, or government controlled or provided.

Basically Trump is saying "the Canadian system delivers shitty healthcare, but we should do it great here, like everything I do, it'll be fabulous, best ever."


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PostPosted: 03/24/17 12:28 pm    ::: Reply Reply with quote

I have no firm idea why Trump is pushing for a vote today on this horrible health care bill, appropriately nicknamed RINO-Care.

Superficially, he perhaps just wants a first legislative victory out of the chute of his campaign promises, no matter what's in it.

Alternatively, perhaps he really doesn't care too much what's in it because he knows the Senate will significantly change it.

Finally, and most cynically, he perhaps hopes the bill goes down in flames and that Paul Ryan gets smothered with the blame. Ryan is a singularly ineffective Congressman and leader, an 18 year member of the House who reportedly has passed THREE pieces of legislation in his entire career. He's exactly the kind of untrustworthy corporatist, globalist and infinite immigrationist -- unflaggingly disloyal to Trump during the campaign -- whom Trump should want to kill in the swamp.

Here's hoping that RINO-Care goes down in nuclear flames today and incinerates the feckless Ryan and the entire Republican "leadership" in the House.
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PostPosted: 03/24/17 12:41 pm    ::: Reply Reply with quote

GlennMacGrady wrote:
Superficially, he perhaps just wants a first legislative victory out of the chute of his campaign promises, no matter what's in it.


This plan is absolutely nothing like what he was promising during the campaign



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PostPosted: 03/24/17 12:46 pm    ::: Reply Reply with quote

pilight wrote:
GlennMacGrady wrote:
Superficially, he perhaps just wants a first legislative victory out of the chute of his campaign promises, no matter what's in it.


This plan is absolutely nothing like what he was promising during the campaign


Absolutely correct . . . and why I'm hoping that possibility is just a "superficial" hypothesis by me.
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PostPosted: 03/24/17 3:51 pm    ::: Reply Reply with quote

Well that's a hoot. Trump blaming the Democrats, that none of them would support his bill.

That's hardly a shock.

This bill was junk, and got worse when they sold out to the right wing by removing the minimum coverages and the like.

He isn't saying a word about the Koch Bros and other groups on the extreme right that threatened conservatives who voted yes.


ArtBest23



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PostPosted: 03/24/17 3:53 pm    ::: Reply Reply with quote

Trump's theory is that Obamacare will collapse, and then some Democrats will want to work out a bipartisan bill. And then they can all put together a better bill.


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