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Anyone else enjoy the Repubs squirming on Obamacare replacement?

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One of my biggest issues with any discussion on "healthcare reform" is that most reform only addresses a single part of a multi piece puzzle.

- You have access to care to consider (how far and to what facility can they get to, is there appropriate staffing, are there beds available, ect)
- You have the actual quality of care to consider (are we doing the right diagnostics, right therapy, appropriate education and follow up)
- You have affordability of care care to consider (are meds, technical charges, supplies, and physician costs appropriate)
- You have the coverage required to pay for this (private insurance, government insurance, high deductible plans, ect)

I'm sure you can get more granular in how you define those, but those are the big things that makeup healthcare.

Plans like this really only address the last one on coverage without making any consideration or improvements to the other three. They are all intertwined and until they step back and take a entirely new look at this as the truly complicated beast that it is, we will never move forward.
 
Oh, but it isn't. Don't pretent you know what is in my head.

I don't I can only go by the words you type here and the logical outcome of your positions. So if you didn't mean that maybe you should try again to articulate your position in a way that says what you actually mean.
 
Trump is making it very hard to be a GOP Senator or Congressman nowadays, regardless of how red their District is. He is making them all look like him. I think he's just upset that it might take away his chance to pretend to drive a fire truck. Yesterday's pictures of him in a big rig are the gift that keeps on giving when it comes to memes.

After all the talk about how great of a deal maker Trump is, it's amusing to find out that his "deal" consists of throwing a bunch of money at the other side and then saying "I'm going home, you guys can keep my ball." Where's the shrewd negotiator?
 
One of my biggest issues with any discussion on "healthcare reform" is that most reform only addresses a single part of a multi piece puzzle.

- You have access to care to consider (how far and to what facility can they get to, is there appropriate staffing, are there beds available, ect)
- You have the actual quality of care to consider (are we doing the right diagnostics, right therapy, appropriate education and follow up)
- You have affordability of care care to consider (are meds, technical charges, supplies, and physician costs appropriate)
- You have the coverage required to pay for this (private insurance, government insurance, high deductible plans, ect)

I'm sure you can get more granular in how you define those, but those are the big things that makeup healthcare.

Plans like this really only address the last one on coverage without making any consideration or improvements to the other three. They are all intertwined and until they step back and take a entirely new look at this as the truly complicated beast that it is, we will never move forward.

The reason for that is pretty simple, just look at how haphazardly they keep adding in new parts to the bill without exploring their costs or consequences. Why are they doing this? This is why:

123115krugman1-tmagArticle.png


This increase in tax rates for the ultra rich is (mostly) the result of taxes on them in the ACA and THAT is what Republicans are primarily concerned with reversing. This is not a health care bill, this is a rich person tax cut bill. Once you view it that way everything makes sense.
 
One of my biggest issues with any discussion on "healthcare reform" is that most reform only addresses a single part of a multi piece puzzle.

- You have access to care to consider (how far and to what facility can they get to, is there appropriate staffing, are there beds available, ect)
- You have the actual quality of care to consider (are we doing the right diagnostics, right therapy, appropriate education and follow up)
- You have affordability of care care to consider (are meds, technical charges, supplies, and physician costs appropriate)
- You have the coverage required to pay for this (private insurance, government insurance, high deductible plans, ect)

I'm sure you can get more granular in how you define those, but those are the big things that makeup healthcare.

Plans like this really only address the last one on coverage without making any consideration or improvements to the other three. They are all intertwined and until they step back and take a entirely new look at this as the truly complicated beast that it is, we will never move forward.

It's complicated because people want it to be. When you start (government) giving tax payers money away for a product, the price of that said product has never decreased. I'll be willing to eat crow, but I don't and have never believed in that philosophy.

When you start treating health insurance like car insurance, you start to decrease the price of healthcare.

You pick your coverage according to your needs
Repair cost are transparent
Cost for rental cars
Cost for road side assistance
Competition across state lines
Etc..

You can't start offering a competitive marketplace without making people pay for things they need. Free things, especially tax subsidies have never decreased costs.

You want to provide assistance for widowed, disabled, or similar, go ahead.
 
The reason for that is pretty simple, just look at how haphazardly they keep adding in new parts to the bill without exploring their costs or consequences. Why are they doing this? This is why:

123115krugman1-tmagArticle.png


This increase in tax rates for the ultra rich is (mostly) the result of taxes on them in the ACA and THAT is what Republicans are primarily concerned with reversing. This is not a health care bill, this is a rich person tax cut bill. Once you view it that way everything makes sense.

Well, yeh, but we all know it'll trickle down. Honest. You betcha. Scout's honor.
 
When an insurance company writes a policy for a car they have fixed amounts they are responsible for. They know exactly how much a car is worth, and how much they are on the hook for if shit hits the fan. On the health care side there is no ending on costs. It can't be accounted for only estimated. They can't plan for a 21 year old to develop leukemia and end up in millions in treatments. Or for a woman to get pregnant and deliver premature multiples costing millions. They can only estimate. And the same goes for me as a human being. I don't know what sort of trauma or terminal condition I could develop tomorrow or what the cost could be for that. But if I total my car I know exactly how much I'm out and what it will cost me to replace. It's not really comparable.

Plus what else is different than the car industry? To drive a car you are required to have insurance. The mandate was part of the ACA. And they want that removed. That's not how insurance works.
 
Gonna be be fun watching Twitler melt down over this one failing this afternoon. I expect lots of tweet storm action after the vote.
 
When an insurance company writes a policy for a car they have fixed amounts they are responsible for. They know exactly how much a car is worth, and how much they are on the hook for if shit hits the fan. On the health care side there is no ending on costs. It can't be accounted for only estimated. They can't plan for a 21 year old to develop leukemia and end up in millions in treatments. Or for a woman to get pregnant and deliver premature multiples costing millions. They can only estimate. And the same goes for me as a human being. I don't know what sort of trauma or terminal condition I could develop tomorrow or what the cost could be for that. But if I total my car I know exactly how much I'm out and what it will cost me to replace. It's not really comparable.

Plus what else is different than the car industry? To drive a car you are required to have insurance. The mandate was part of the ACA. And they want that removed. That's not how insurance works.

Not to mention the fact that we as a society are perfectly comfortable with the idea that if you lack car insurance and wreck your car that you have to take the bus. We are not comfortable with letting people without health insurance die. (at least not immediately) That doesn't even get into the fact that cost transparency for your overall costs is often impossible for regular people to achieve (one hospital will charge twice as much for one part of a procedure and half as much for other parts) and that health care dispensers for expensive illnesses often don't have competitive markets in plenty of areas.

The comparison between health insurance and car insurance sounds good until you spend literally any time thinking about either one.
 
You want to provide assistance for widowed, disabled, or similar, go ahead.
Medicaid money goes here:
* 34% goes to the blind and disabled
* 14% goes to the elderly (that frequently means those who are widowed since women generally live longer)
* 19% goes to children (I'll take liberty and call that "similar" from your post).

So what is the main change that the Republicans are doing with this bill? Slash medicaid spending; which mostly goes to the widowed, disabled, or similar.

You are correct that government purchasing supports generally raise prices. But this proposed bill does virtually nothing for prices and does everything to cut items that you said you would support.
 
Gonna be be fun watching Twitler melt down over this one failing this afternoon. I expect lots of tweet storm action after the vote.

The outcome seems up in the air. Even if they get it passed this should, in theory, be the easiest part of the process. The Senate is going to rip this bill a new one and I think it's doubtful that they and the fractured house will ever agree on something that can pass both chambers.
 
The outcome seems up in the air. Even if they get it passed this should, in theory, be the easiest part of the process. The Senate is going to rip this bill a new one and I think it's doubtful that they and the fractured house will ever agree on something that can pass both chambers.
Unless they do the unthinkable but quite possible if they had the willpower: propose a bill that democrats and moderate republicans can both support. There is massive common ground that both sides can agree upon. But because of the D or R next to their 2018 ballot, they won't.
 
Unless they do the unthinkable but quite possible if they had the willpower: propose a bill that democrats and moderate republicans can both support. There is massive common ground that both sides can agree upon. But because of the D or R next to their 2018 ballot, they won't.

Next bill: Rename Obamacare to Republicare. No other changes. Just name.

Done.
 
Unless they do the unthinkable but quite possible if they had the willpower: propose a bill that democrats and moderate republicans can both support.

I suppose it's possible but given the comments coming out of the Senate it would seem they want to dispose of this bill rather than re-write it.
 
That is exactly where this failure belongs.
I agree with you on this one. This pile of poop is all on Ryan, McConnell and the Congressional Republicans. Trump, much like Obama did with the ACA, opened the door to a new plan but didn't formulate a plan and abdicated to Congress to come up with something. Trump, despite his braying, has not offered a plan.
 
I agree with you on this one. This pile of poop is all on Ryan, McConnell and the Congressional Republicans. Trump, much like Obama did with the ACA, opened the door to a new plan but didn't formulate a plan and abdicated to Congress to come up with something. Trump, despite his braying, has not offered a plan.
but...but it was going to be better, bigger and cheaper. Trump said it would. We believed him!

SUCKERS!!!
 
Medicaid money goes here:
* 34% goes to the blind and disabled
* 14% goes to the elderly (that frequently means those who are widowed since women generally live longer)
* 19% goes to children (I'll take liberty and call that "similar" from your post).

So what is the main change that the Republicans are doing with this bill? Slash medicaid spending; which mostly goes to the widowed, disabled, or similar.

You are correct that government purchasing supports generally raise prices. But this proposed bill does virtually nothing for prices and does everything to cut items that you said you would support.

They just removed the mandates required for all. So, that adds some flexibility. I didn't mean elderly, but those widowed, however, what's the rest of Medicaid going towards? If you want to keep essential care, I think those items highlighted are ok, and nothing more. I mean for god's sake, 20T in debt isn't going to be manageable much longer.
 
but...but it was going to be better, bigger and cheaper. Trump said it would. We believed him!

SUCKERS!!!
It will be cheaper, but not by much. Once you give things away for free, it's quite hard politically to take them back. Until we reach the breaking point, don't expect medical cost to decrease.
 
I don't I can only go by the words you type here and the logical outcome of your positions. So if you didn't mean that maybe you should try again to articulate your position in a way that says what you actually mean.


I did. Don't blame me because you cannot understand it.
 
I agree with you on this one. This pile of poop is all on Ryan, McConnell and the Congressional Republicans. Trump, much like Obama did with the ACA, opened the door to a new plan but didn't formulate a plan and abdicated to Congress to come up with something. Trump, despite his braying, has not offered a plan.

Well it actually isn't his job to actually write a plan... An outline of what he wants OK, but the plan belongs to congress. And they all suck, both sides.
 
I mean for god's sake, 20T in debt isn't going to be manageable much longer.
The debt must not be a big deal because this Republican bill is a huge tax cut for the rich. If water pouring in is an issue, one generally doesn't run for a smaller bucket.
 
They just removed the mandates required for all. So, that adds some flexibility. I didn't mean elderly, but those widowed, however, what's the rest of Medicaid going towards? If you want to keep essential care, I think those items highlighted are ok, and nothing more. I mean for god's sake, 20T in debt isn't going to be manageable much longer.
The rest of the Medicaid money (32%) goes to poor adults who can't afford insurance. I think that section of the spending is what many people find distasteful. But that is only if you look at half of the picture. We were paying for their health care anyways through bankruptcies and non-payments of medical bills. So reducing official spending on Medicaid for the poor doesn't help with the problem because we just pay for it in unofficial ways.

Our $19.85T of debt is quite manageable at the moment. That is 10% higher than our $18.04T of GDP. It is the equivalent of someone earning $100k having a $110K mortgage which almost everyone would consider to be quite manageable. Your point is correct though, that debt is growing faster than GDP and will one day become unmanageable. Obamacare, however, isn't the cause of the growing debt. The taxes in Obamacare are higher than the spending in Obamacare. So, getting rid of Obamacare makes our debt worse.

To fix the debt, we need to (a) promise less in the future especially on Medicare, Social Security, and Military spending and (b) tax more now to match the promises that we have already unfortunately made. Both are political suicide. It is far easier for a politician to promise to tax less and spend more (Trump for example won on that very promise with tax cuts and massive infrastructure spending).
 
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