quote:

Why can't they just simply write, "The individual mandate is hereby abolished",

here is my opinion of the answer. I am not an expert.

The legislative filibuster is a Senate policy. It is not in the constitution.

But you need 60 senators to introduce a bill for a vote. Once the bill gets on the floor for consideration, you only need 51 votes to pass it.

Cloture is the procedure for ending the initial debate and taking a vote. You need 60 votes to end cloture.

This is what the REPs just changed for Supreme Court nominations to get Gorsuch confirmed.

There is a way past the initial cloture 60 vote requirement for "reconciliation" where the bill only addresses tax and spending adjustments. That only needs the 51 votes to pass. Reconciliation issues can't be filibustered.

With the 48 DEM senators, they can block legislation from passing in the Senate.

So the REPs had to carefully tailor the bill HR 1628 so it only addresses tax and spending. That way it fell under reconciliation.

We won't get by the DEM Senate filibuster with a broad bill that does things like "the individual mandate is abolished".

Like I wrote earlier, I may not be completely accurate on this.

quote:

So the REPs had to carefully tailor the bill HR 1628 so it only addresses tax and spending. That way it fell under reconciliation.

That's correct. But my previous answer was only half joking!

So how many new doctors and nurses will this revised system create by 2020? Seem like zero to me. I know about a dozen docs who quit because of what Obama and his actions did.

Saying the mandate is repealed as though that's a meaningful and useful victory is one of those irritating political half-truths that exemplifies so much of what's wrong with politicians and government. Sure, it's repealed, and - equally importantly - it's simply shifted to another area - where the industry charges you instead of the government.

I fucking detest that sort of bullshit, literal bullshit that's intended to deceive the people.

Many of the other cuts and points, however, seem Letty good.

quote:

Originally posted by 46and2:
Saying the mandate is repealed as though that's a meaningful and useful victory is one of those irritating political half-truths that exemplifies so much of what's wrong with politicians and government. Sure, it's repealed, and - equally importantly - it's simply shifted to another area - where the industry charges you instead of the government.

I fucking detest that sort of bullshit, literal bullshit that's intended to deceive the people.

But in this case it is literally true - there is no mandate to buy health insurance and no penalty if you do not choose to buy it.

They did allow insurers to charge a 30% premium to someone who signs up for coverage if they haven't had coverage in over a year. That surcharge can be applied for one year to their premiums.

That seems fair to me - some people do not want to buy insurance and they shouldn't be penalized for making that choice. Insurers shouldn't be expected to cover them at the same cost if they sign up for coverage after they get sick.

quote:

it's simply shifted to another area - where the industry charges you instead of the government.

IF you buy insurance. Now you can make a choice.

quote:

Originally posted by BamaJeepster:

quote:

Originally posted by 46and2:
Saying the mandate is repealed as though that's a meaningful and useful victory is one of those irritating political half-truths that exemplifies so much of what's wrong with politicians and government. Sure, it's repealed, and - equally importantly - it's simply shifted to another area - where the industry charges you instead of the government.

I fucking detest that sort of bullshit, literal bullshit that's intended to deceive the people.

But in this case it is literally true - there is no mandate to buy health insurance and no penalty if you do not choose to buy it.

They did allow insurers to charge a 30% premium to someone who signs up for coverage if they haven't had coverage in over a year. That surcharge can be applied for one year to their premiums.

That seems fair to me - some people do not want to buy insurance and they shouldn't be penalized for making that choice. Insurers shouldn't be expected to cover them at the same cost if they sign up for coverage after they get sick.

A 30 percent surcharge is peanuts so I don't see how that is fair.

If insurance costs $8000 a year then the 30 percent surcharge is $2400. If the person now wants to buy insurance because has something seriously wrong with him the treatment could cost hundreds of thousands of dollars.

Fair points. ^

But I think that thinking a 30% surcharge (on anything) "is peanuts" is, itself, "crazy".

It's actually for a lapse in coverage of 63 or more days. That doesn't sound at all good for some people if you lose your insurence through your employer and, how in the hell does one afford the high cost
of Cobra? It seems to go from a premium to paying for an entire policy, out of pocket. But whatever it takes to line the pockets of the insurence industry.

Don't worry, insurance companies, and drug companies will still be able to extort you to taking medication that you probably don't need. And if you do not, they will charge you a lot more in fees.

Trump Praises Single Payer Healthcare

Hours after a raucous celebration for the 1/3 passage of the American Healthcare Act on the White House lawn, President trump sat with Australian Prime Minister Malcolm Turnbull, and praised their country’s single payer healthcare system. Apparently he realized the mistake as he was saying it, but it didn’t stop him from finishing: “I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do, but we’re going to have great healthcare very soon.”

Sigh.

Of course, it’s not that surprising he feels this way, since he’s said it many times before. Remember, he praised Canada and Scotland’s single payer systems during the Fox News primary debate in 2015, and repeated it during his 60 Minutes interview later than month. He has praised it in many other interviews for NBC, The Advocate and on Larry King Live. But, the fact that he did it on international television, just hours after celebrating partial passage of a privatization effort is what is upsetting.

It wasn’t long before Senator Bernie Sanders, bursting into laughter, promised to quote the president on the floor of the Senate when they debate their own version of the bill (see video):

“Thank you Mr. President. Let us move to a Medicare for all system that does what every other major country on earth does: guarantee health care to all people at a fraction of the cost per capita what we spend. Thank you Mr. President. We’ll quote you on the floor of the Senate.”

Crap.

While I’m happy about movement in the right direction with today’s bill, it’s more of a relief in progress than happiness in accomplishment. The American Healthcare Act is far from perfect, but it’s an improvement on what we currently have. It repeals the two mandates that galvanized us seven years ago, the Individual Mandate and the Employer Mandate. It also repeals eight massive taxes that were draining our economy. That being said, the fact that it took this much effort to move half a step forward is concerning, and it has Charles Krauthammer predicting single payer healthcare for the United States in “less than seven years.” Not if I can help it.

Today’s very public concession that single payer healthcare is better than our own is going to do more to damage our effort than Obamacare’s failure.

THE TIME IS NOW

In the months ahead, we have a one time shot at pushing this further, to an actual free market as Obamacare fully implodes, or single-payer’s failure is our future.

Conservatives have long known that healthcare lacked a truly free market for 50 years. Before the ACA, there were no market forces in play on price, competition or transparency. Any economist knows that these things inform producers how to best deliver service, and help consumers decide where and how to spend their money. This, in turn has led every industry in history to lower prices, efficient costs, greater access and a scale of quality decided on by the customer.

The reality is that truly single-payer healthcare is rare, and for a reason. Sweden is moving back to one with private insurers because it’s system is failing. Most French citizens are covered by supplemental insurance because the government insurance isn’t enough and is going broke. Germany has over 150 different insurance funds to help supplement government coverage. And yes, even Australia knows it’s facing funding issues, despite it’s relatively homogenous population. Finally, the motherland now ranks itself as one of the worst healthcare systems in the developed world.

Interestingly, Ezra Klein, a single payer proponent, has admitted the the US system fails because neither the free market, nor the government determines prices and costs. “That leaves the United States with the worst of both approaches. We simultaneously miss out on the efficiency of a purely private system and on the savings of a purely public one.” The result is we pay more for inexplicable reasons, and the government sets the lowest standard for it’s own inexplicable reasons.

Thank you, Ezra, we should use that on the Senate floor.

Our system is not tenable. It wasn’t tenable before the ACA, and it’s worse now. We need true reform that introduces those market forces for the first time in decades, and allows them to drive down costs, force prices lower, increase access and keep quality in the hands of consumers. In turn, insurance will become cheaper because what it’s paying for is cheaper.

The time is now, not later. With one step forward today, we need to keep pressing for incremental change. It worked for the progressive left for 150 years. We could learn something from that.

http://theresurgent.com/there-...le-payer-healthcare/

quote:

Originally posted by chellim1:
Trump Praises Single Payer Healthcare

Hours after a raucous celebration for the 1/3 passage of the American Healthcare Act on the White House lawn, President trump sat with Australian Prime Minister Malcolm Turnbull, and praised their country’s single payer healthcare system. Apparently he realized the mistake as he was saying it, but it didn’t stop him from finishing: “I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do, but we’re going to have great healthcare very soon.”

Sigh.

Of course, it’s not that surprising he feels this way, since he’s said it many times before. Remember, he praised Canada and Scotland’s single payer systems during the Fox News primary debate in 2015, and repeated it during his 60 Minutes interview later than month. He has praised it in many other interviews for NBC, The Advocate and on Larry King Live. But, the fact that he did it on international television, just hours after celebrating partial passage of a privatization effort is what is upsetting. . . .

http://theresurgent.com/there-...le-payer-healthcare/

It seems to me that these kind of articles miss the point. Candidate and President Trump was and is driven by what will get the people access to health care.

That does not mean that when he sees another system get care to large numbers that he is endorsing single payer. He is praising a system that covers people.

Can we get health care delivered in a better way? I like to think we can. President Trump says he wants better than what we have now and better than what other countries can deliver in their socio/economic systems.

There is such a predictable rush to stamp President Trump with something other than what he says he seeks.

This article is from a predictable source - the same ones that doubted he would select a Supreme Court Justice from a conservative list?

Sigh.

an article that makes some good points:

https://townhall.com/columnist...rking-boffo-n2328766

Instead of creating a better marketplace Obamacare destroyed the marketplace for health care by making it impossible for insurers to predict costs. Without that they cannot properly price their product. Thus, Obamacare provided Americans little or no competition for their insurance dollars and created soaring costs. In addition, the individual mandate that was supposedly forcing everyone to buy insurance was a near complete failure.

On May 5th, the devilish duo behind Obamacare – Jonathan Gruber and Ezekiel Emanuel ran dueling dissertations in the Washington Post on how the Republicans are at fault for the problems with their dismal plan. If the Republicans only forced people to buy the health insurance they don’t want on the exchanges, the plan would be saved. If Republicans only gave the plan more time –the 2017 massive premium increases were a one-time adjustment of costs. If they only threw more money at insurance companies to underwrite their losses.

Aetna has pulled out of the Exchanges. Blue Cross in Maryland, Virginia and D.C. has already requested a 52%, 35% and 29% increase for 2018 respectively. Maybe, Gruber and Emanuel should read the newspapers and get closer to reality. Aetna has already lost $500 million since 2014 on their failed plan.

The Democrats are crowing about a plan (Obamacare) where they lied to Americans about the basics of their healthcare (you can keep your plan and your doctor), which has crushed the competitive marketplace for insurance and driven up its costs and out-of-pocket expenses.

The plan desperately needed an overhaul, yet, they voted unanimously in the House to keep this damaged plan that was spiraling down and potentially out of control.

As an end to the cost sharing arrangement could lead an even bigger exodus of insurers from their own business of selling insurance, which would of course be blamed on Trump, Trump is asking for another 90 days of cost sharing.

It seems like some bullets must be bitten....:

White House wants to continue Obamacare cost sharing payments for another 90 days

Yesterday Allahpundit noted a report saying that President Trump was once again thinking about cutting off Obamacare’s cost-sharing payments. Today, Politico reports Trump is planning to kick the can down the road:

The Trump administration Monday plans to ask a federal court for another 90-day delay in a lawsuit over Obamacare insurance subsidies, according to two administration sources, leaving the future of the health care marketplaces in limbo through late August…

While another delay would stop short of imploding the markets, it still undermines the exchanges, by continuing uncertainty as insurers decide where to offer coverage and how to price it.

Politically, this has become a very tough issue for the President. Insurers are now deciding whether or not they will stick with Obamacare in 2018. If Trump cuts the payments now he could cause Obamacare to collapse but there’s little doubt he would be blamed for it. He could also promise to fund the payments indefinitely, which would create stability in the markets and allow insurers to keep their rate requests somewhat lower. That way he doesn’t get blamed if it collapses, but on the other hand, he’d literally be supporting the law he promised to repeal.

So Trump is splitting the difference. He’s not cutting the payments immediately, but he’s also not promising to pay them indefinitely. The markets will limp along as rates go up to account for the uncertainty, but they won’t collapse all at once.

Meanwhile, Democrats are now interested in investigating whether or not the Trump administration linked the continuation of the cost-sharing payments to support for the GOP’s replacement plan. From the LA Times:

At the April meeting, according to multiple industry officials interviewed by The Times, [CMS Administrator Seema] Verma linked the aid to the House repeal legislation, telling insurers the aid wouldn’t be paid until the House bill passed, while also asking health insurers to endorse the bill.

The suggestion that the payments were connected to the industry’s support for the Republican bill stunned industry officials.

“It made no sense,” one told The Times.

Jane Norris, a spokeswoman for the health agency, said The Times’ account was “completely false.”

Democrats can try to play hardball on this issue, but the White House really can stop the payments at any time by simply dropping its objection to the lawsuit. I guess the real question is whether Democrats are still trying to keep Obamacare alive or have decided it’s a lost cause. If it’s the latter then all that’s left for them to do is find a way to blame the failure on someone else.

http://hotair.com/archives/201...nts-another-90-days/

It took a little bit but I sat down and read the whole thread. I learned some interesting stuff, particularly about rolling insurance in as an employment benefit, tax deductible to the employer. I wonder if taking away the tax deduction for employer provided healthcare would create or solve more problems. It would disincent companies to provide health insurance and invent them to just pal employees more and let them buy their own insurance. This might help the individual market, but would employees be worse off?

I suspect that it will not be easy to cut off and remove the tentacles of ObummerCAIR twisted through our economy and life. I wish our legislators and President much dedication, focus, and luck on getting the job done.

If I understand correctly having private employers as health care providers has historically been a big deal because of taxes and administrative costs. The company and employee pay less taxes, and companies give employees lower health care costs by negotiating for a pool of employees. Companies also got used to providing it as a form of compensation that was theoretically cheaper than simply paying employees what it would have cost them to get insurance on the private market. The government gets more people insured so that there's fewer people that the government or hospitals have to pay for, and does so with theoretically lower administrative costs.

In theory, anyone (private people in co-ops, employers, insurance companies, government) can put together a pool of people to negotiate for better services and lower costs. In theory, the government can find any number of ways to reduce taxes on employers to the extent that they offer employees some kind of help with health care. In theory companies can continue to provide a health care package as part of compensation that costs them less than it would otherwise.

The questions to answer are how that health care is provided and who deals with the administrative hassle and costs of making sure it all gets done. The "how" is pretty straightforward, since whoever is responsible for this is just going to pick a company (or agency) that's in the buisness of providing that service. The big opportunities to save money and avoid hassles (IMHO) lie in deciding who's responsible for picking up the phone and hiring a healthcare company.

I would point out that people who are self-employed or otherwise unable to get health care from an employer have, from time to time, gone through a union, guild or other organization they've put together in order to get health care as a group while still keeping some control over their options.

May 31, 2017
The coming shortage of doctors can be blamed on Obamacare

Some alarming reports from physician organizations predict that by 2030, there will be e near catastrophic shortage of primary care doctors and specialists in the United States. This is due to a combination of fewer people entering medical school and a huge number of doctors indicating they will take early retirement.

The blame for so many doctors leaving the profession can be placed on Congress and the regulatory burden placed on physicians by Obamacare.

Washington Examiner:

A 2016 report from the Physicians Foundation found an alarming growth in burnout and dissatisfaction among practicing physicians – 47 percent of respondents in the survey indicated plans to "accelerate" their retirement and move into areas outside of clinical medicine.

The most common reason for leaving medicine included regulatory burdens and electronic health records. Nearly 63 percent indicated that they have negative feelings about the future of healthcare and only half of all physicians would actually recommend a career in medicine to their children. Many of my colleagues feel they have no voice and have no way to impact healthcare policy – even in their own institution.

As regulatory requirements and non-clinical tasks continue to mount, physicians are finding themselves spending less and less time with patients. According to 2016 research from the Annals of Internal Medicine, most doctors only spend 25 percent of their day engaging with patients – the bulk of the time is spent on non-clinical electronic and regulatory paperwork. In fact, for every hour of direct patient contact, physicians have an additional 2 hours of electronic paperwork.

Most of this is due to either mandatory electronic medical record coding (to help the hospital systems bill at the maximal levels) or due to government-mandated documentation (such as asking about gun use during office visits – most of which has never shown a survival or outcome benefit).

These statistics should be incredibly troubling for all Americans seeking healthcare. With access already an issue in the healthcare system for many and more reforms on the way, we must do more to entice bright young minds to medicine – and retain those that are currently delivering care to millions of patients.

These figures should not come as a surprise to anyone who has been studying the effects of Obamacare on the entire health care industry.

http://www.americanthinker.com...ed_on_obamacare.html

the GoP better get on board with the agenda, or find themselves being actively campaigned against in 2018

these dickweeds have one chance to show what side they're on

Despite perpetual thorn in side, Sen. Susan Collins (R-ME) ....

Senate Republicans Allegedly Moving Closer to Obamacare Repeal Deal:

Senate Republicans are moving closer to a deal on health care reform despite their differences on Medicaid spending.

Senate Majority Leader Mitch McConnell (R-KY) expressed delight that the Senate is edging closer to a deal on health care after three hours of closed-door meetings. McConnell told reporters, “We’re getting close to having a proposal to whip and to take to the floor.”

McConnell works with a hard whip count. The Senate can only afford to lose two of his chamber’s Republican seats, with Vice President Mike Pence to break the tie. At the moment both Sen. Rand Paul (R-KY) and Sen. Susan Collins (R-ME) remain skeptical towards the bill. Sen. Shelley Moore Capito (R-WV) hopes for a slower rollback of Obamacare’s Medicaid expansion. Pushing for a more moderate bill to appease Sens. Capito and Collins might lose the votes of more conservative senators such as Rand Paul, Ted Cruz (R-TX), and Mike Lee (R-UT).

Even with the complex balancing act, Sen. Mike Rounds (R-SD) remains optimistic. He said, “This is what I was hoping to have the leadership be able to share with us, and I feel very good about the fact that we’re moving in the right direction.”

The Senate bill contrasts with the House-passed bill on several key planks. The Senate bill would cut Medicaid at a slower rate compared to the House’s American Health Care Act (AHCA) and offer more generous tax credits for older Americans. The Senate’s proposal would not allow insurers to set higher prices for people with pre-existing conditions compared to healthy people.

Senator Cassidy (R-LA), a moderate force in the health care vote, said he was comfortable with the broad strokes of the health care bill, even though he has not seen the legislation yet. Cassidy explained that protections for pre-existing conditions and slower roll back of the Medicaid expansion were instrumental in his support for the bill.

“What we’ve been told so far, states would have the ability, a lot more power than they do under Obamacare, to shape their future, and I think we’ve gotta return the power to the states,” the Louisiana senator said, potentially referring to state waivers for certain Obamacare regulations or per-capita cuts to Medicaid spending.

According to the Congressional Budget Office (CBO), the House’s AHCA would save $834 billion over the next ten years by cutting Obamacare’s Medicaid expansion. Slowing the phaseout of Medicaid expansion would cost more, though it would give low-income Americans and states more time to adjust.

Sen. Ron Johnson (R-WI) believes that the Senate needs a slower rollback of Obamacare’s Medicaid expansion. “I don’t want to pull the rug out from under anyone,” Johnson said, “but let’s not leave the rug out there for a couple more years to have more people stand on the rug.”

http://www.breitbart.com/big-g...deal-on-health-care/