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Thursday, July 13, 2017

On Days Like This...

...I'm glad that I am not, and never have been, a member of the GOP.

I'm referring to my disgust with the GOP's failure to keep their long-standing promise to repeal (and replace?) ObamaCare — not to Donald J. Trump, Jr.'s emails and his meeting with the Russian lawyer Natalia Veselnitskaya.

Note: please read the second link above, GOP cave on Obamacare repeal is the biggest broken promise in political history, before commenting on the topic.

55 comments:

  1. We can do endless amounts of giving to the world in blood and treasure yet cannot take care of the most important aspect of Americans? That being adequate healthcare? It is absurd. A trillion bucks spent in that cesspool called the Middle East. Yet they toy with us and think we will take it. Maybe Congress will cut their vacation short? Really?
    I do blame the Dems big time. They have so entangled Medicare, Medicaid and Obamacare that it is nearly impossible to repeal. But they must find a way and unravel it one string at a time. But it will take those who work in healthcare not politicians to do it. Time is running out.

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    1. Bunkerville
      ObamaCare has tentacles throughout our healthcare system. Because Obama was elected to a second term, ObamaCare's tentacles are well nigh set in cement. But what I'm saying here begs the question:

      Should the federal government be so nvolved in healthcare provision in the first place?

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    2. Only in the sense of offering consumer protection, regulation, if even that.

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  2. TheGOP is certainly not blameless in this; they have increased the size and scope of government every year they've been in power....so it's not terribly surprising that given 7 years and multiple [I lost count], feeble attempts to repeal the ACA....they seem not to have had a plan nor a strategy for once they regained power, which the have now in all three branches of government.

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    1. The problem for the GOP is that the repeal is a moving target. thousands of pages of rules and regs that all need to be dealt with. The dirty little secret is that medicare and especially Medicaid reimbursements don't begin to cover the cost of services provided. All these years private insurance companies have made up the loss with their reimbursements for services. Healthcare Insurance companies compared to other industries have one of the lowest profit margins. Once the reimbursements get fiddled with, it will be the end of market driven insurance and the Dems will get their single payer plan. So the conservatives want no Federal funding to go to insurance companies. What will happen is they will simply walk away. Most have gone out of business anyway.

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    2. Bunkerville,
      EXCELLENT POINTS!

      I think that few Americans understand the "dirty little secret" that you mentioned.

      Ugly fact: covering those with pre-existing conditions will not work unless there are MANY low-risk insureds in the pool.

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    3. CI,
      Agreed! Another factor: the GOPers on Capitol Hill will not vote as a bloc. The DerMs will.

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    4. Bunker - fair points but still begs the question of why did they embark on a quest to merely rack up legislative losses?

      Not that healthcare is a function of the federal government to begin with....

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    5. @Bunker,

      "Once the reimbursements get fiddled with, it will be the end of market driven insurance and the Dems will get their single payer plan."

      I'm afraid so. Now just imagine the single payer plan known as MEDICARE and its current >$79,000,000,000,000 of un-funded liability doubled or tripled or...... I'm tired of hearing this financial train wreck referred to as "Insurance" along with coverage of "pre existing conditions". Did anyone ever hear about buying collision insurance, post accident? All I can say is that I'm glad to be as old as I am.

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    6. "Pre-existing conditions" begs definition.
      If you have been paying insurance and are forced to change providers, there should be some "exchange" mechanism that allow you to gain new coverage without bankruptcy involved. Or to keep you from being dropped.
      Enrolling for the first time with no history of contribution is a different thing.

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    7. I agree Ed. But how to implement going across State lines? State Insurance Commissions approve Insurance rates and coverages. This whole hogwash notion that they are arguing for that people should be able to go across State lines is a non starter.
      In addition, reimbursements for care differ from one company to another. A Hospital may get $35 for a certain visit, and from Insurance B $15.00. I agree in principle with you.

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    8. CI-- Why did they embark on this? Few have any idea or understand the complexities. There is no repeal and going back to where we were, Sounds good on paper. I have worked In Hospital operations for years....it takes gobs of administrators and so called experts to even try and understand the processes.

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    9. Bunkerville, I always wondered at the legality of an eye glass vendor having two prices: one for insured, one for not.
      Who would complain?
      But how is it right?

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    10. Ed,
      Enrolling for the first time with no history of contribution is a different thing.

      It seems that one's history of contribution doesn't matter when insurance companies are switched -- particularly if one does not have employer-based insurance.

      I agree with you about the following:

      If you have been paying insurance and are forced to change providers, there should be some "exchange" mechanism that allow you to gain new coverage without bankruptcy involved.

      BTW, almost everyone has some sort of "pre-existing condition" by the age of 40. Mr. AOW and I discovered that the hard way when he lost his job. We kept the very expensive COBRA coverage; then, when it ran out, BlueCross rated him even higher than COBRA for "pre-existing condition" -- never mind that BlueCross had long been our health insurance company. It seems to me that we, along with Mr. AOW's employer, had paid our dues to the health insurance industry. Apparently, no.

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    11. Bunkerville @ CI,
      There is no repeal and going back to where we were

      That's what I'm starting to understand! So many complexities!

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    12. Jon,
      I'm tired of hearing this financial train wreck referred to as "Insurance" along with coverage of "pre existing conditions". Did anyone ever hear about buying collision insurance, post accident?

      Most Americans are not thinking that way, are they? Instead, they have come to believe that healthcare is a right -- and they want the government to "buy" the "insurance" for them.

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    13. I was involved with a discussion on "natural" rights vs. "statutory" rights.
      The latter trying to legitimize health care "rights".

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    14. @Ed,

      "If you have been paying insurance and are forced to change providers, there should be some "exchange" mechanism that allow you to gain new coverage without bankruptcy involved"

      I have no problem with that, however, Insurance, as I know it, does not provide for this. Perhaps there should be some sort of a Pre Existing Condition Fund but any way that you look at it there is a COST involved. Insurance carriers are required to maintain "reserves" for accrued liabilities which include future pay-outs. In order to maintain financial viability they not only collect premiums but also invest in all sorts of public/private resources. If the Medicare model is an example of what this "single payer" system will be like it seems pretty clear to me that [it] will be financed by little more than mounting debt. At some point [debt] must be paid. How will that be accomplished? If the Medicare un-funded liability is >$79,000,000,000,000, as reported, and our present population is, let's say, 320,000,000 it looks like our per capita debt for that alone is some $246,875. So just how will the "single payer" system, for everyone, work in the hands of government? Reality isn't always nice but it is always reality!

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    15. Michigan as a state already has this mechanism.
      Has for longer than Ocare.

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  3. White knights will always prove to represent a turn towards the elitist factions of both political parties. Donald Trump, Bernie Sanders. It matters not. The people don't want to rule. They want to BE ruled and carp about how poorly it's being done.

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    1. Thersites,
      There is a certain security in being ruled.

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    2. “Those who surrender freedom for security will not have, nor do they deserve, either one.” ― Benjamin Franklin

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    3. Surely paper and ink costs could be cut by replacing Social Security checks with form letters that say "F*ck you for trusting government, dumbass. Didja learn anything?"

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  4. Repubelicans are shameless liars, scammers and Big Government statists, just like their incestuous cousins, the DemonCraps.

    If DC suddenly slid off into the Atlantic and disappeared, the nation would be immediately improved.

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    Replies
    1. The Potomac and Patauxent aren't the Alfeios and Pineios, and Donald J. Trump is no Heracles (5th Labour).

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  5. There are good republicans and bad Republicans.
    I can't say that for Democrats.
    The term RINO has no meaning anymore as the Republican name is no longer a statement of principles (unless you count the platform of the last election).

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  6. There are two thrusts to the quandary.
    1) The dems block the Senate vote on anything but reconciliation, and reconciliation is limited in scope.
    2) The R's probably would not go in the direction we'd prefer anyway due to electoral pressure to keep the freebies flowing.
    If McConnell changed the rules to 51 votes (is he not doing so to give cover?), would the repubs come forth with a master plan we would find acceptable?

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  7. The repeal of of Obamacare is nothing more than a blatant tax break to the wealthy. And those who voted for Trump finally realize they will be the first to be screwed over.

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    1. Yeah. I didn't follow that either...

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    2. Ed, a feature of the Affordable Care Act is various tax measures including a 0.9 percent payroll tax on earnings and a 3.8 percent tax on net investment income (NII) for individuals with incomes exceeding $200,000 and couples with incomes exceeding $250,000.

      Under the proposed pan a primary objective is to repeal that tax and avoid the resulting deficit by removing Medicaid coverage.

      Debate that on the merits but don't pretend this isn't a tax repeal effort first and foremost.

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    3. Well, now I know, but I don't believe the primary goal of this repeal effort is tax relief for the rich.

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    4. Repeal the tax on my 401k? Woohoo!


      Oh wait, they didn't. And won't.

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    5. This comment has been removed by a blog administrator.

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    6. "According to the same analysis, those earning more than $1 million a year would see a tax cut of $51,400 a year, on average."
      Like they'd notice.

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    7. Average "net" transfer amounts favor the 1.5% of rich people earning over $200K per year as your chart shows. But the TOTAL and absolute transfer of wealth favors the one in three people in the middle class who earn a meager $50k a year or more and who actually PAY income taxes (as opposed to loop-hole out of them like Warren Buffet... who's secretary pays more in income taxes).

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    8. See that Cadillac tax? 25% of workers will soon be paying it, and since it's not indexed for inflation, soon EVERYONE will (not just "rich" 1%-ers)

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    9. Also notice (from the Cadillac tax chart) that with ten years of passage, the total taxes related to the ACA TRIPLED, going from $30+B/year to $130+B/year. That's at least a 10% annual "inflation" rate on a TAX. How much of a "raise" did Social Security recipients get this year? 2.6%... the BIGGEST increase in the past 6 years! Yet this 10 year, 10% annual TAX increase for medical coverage which WORKERS that have to pay so that MEDICADE recipients can sit on their butts is "fair" to you you Lefties...

      *Amazing*

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    10. No wonder working people HATE Democrats!

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  8. If the law isn't changed, we'll ALL be paying the Cadillac tax!

    The ACA imposes a 40% excise tax on high-cost group health coverage, also known as the “Cadillac tax.” This provision taxes the amount, if any, by which the monthly cost of an employee’s applicable employer-sponsored health coverage exceeds the annual limitation (called the employee’s excess benefit). The tax amount for each employee’s coverage will be calculated by the employer and paid by the coverage provider who provided the coverage.

    Although originally intended to take effect in 2013, the Cadillac tax was immediately delayed until 2018 following the ACA’s enactment. The 2016 federal budget further delayed implementation of this tax for an additional two years, until 2020. The 2016 federal budget bill also:

    Removed a provision prohibiting the Cadillac tax from being deducted as a business expense; and
    Required a study to be conducted on the age and gender adjustment to the annual limit.
    There is some indication that this additional delay will lead to an eventual repeal of the Cadillac tax provision altogether. Over the past several years, a number of bills have been introduced into Congress to repeal this tax. Although President Trump has not directly indicated that he intends to repeal the Cadillac tax, he has stated that repealing and replacing the ACA is a main goal for his administration.

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    1. I love the way they phrase this... as an "excess benefit".

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    2. The Patient Protection and Affordable Care Act (PPACA, as amended by the Health Care and Education Reconciliation Act of 2010), imposes an annual 40% excise tax on plans with annual premiums exceeding $10,800 for individuals or $29,500 for a family starting in 2020, to be paid by insurers.[4][7] The tax is not imposed on the total cost of the plan, but on the costs exceeding the aforementioned values, which, after 2020, will adjust to inflation annually. These costs include any part of a person's income allocated to flexible spending accounts, health reimbursement accounts, and health savings accounts, but not expenditures for stand-alone dental, vision, accident, disability, or long-term care insurance coverage.[7][8] The tax is not a deductible business expense and so plan administrators pay income tax on the excise tax, significantly increasing the effect of the 40% tax.[8] The tax is intended to do three things: help finance the PPACA; reduce overall health care costs; and address the unequal tax benefit of excluding employer-based health insurance coverage from taxes.[9]

      Although the tax plan was positioned to combat a "luxury", it is not indexed for the increasing costs of care. This means as healthcare costs rise, more employees' plans will be subjected to the tax. It also will impact, possibly eliminate, some healthcare savings accounts which are included in the plan cost calculation. A study from the nonpartisan Kaiser Family Foundation estimated 26 percent of all employers would face the tax in at least one of their plans in 2018 when the taxes are first implemented.[10] Labor union have also opposed this tax because it would be "very disruptive" to their generous healthcare plans and have asked that their members to be eligible for the same federal subsidies available to low-income workers in the new health exchanges.

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  9. The GOP's HC bill sucks. Repeal and work on the fringe problems is the way to go. And Tort Reform! haven't heard that mentioned since the election was over. Damn lawyers must have one hell of a lobby.

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    Replies
    1. Kid,
      Yep.

      Amazing what those lobbyists can do. Amazing in a bad sense, that is.

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  10. There's nothing left to say but

    EREISSARBDRATSABHOHCTIBOHTRAFHO
    TITHOTNUCHOWERCSHOKCUFHOKCUSHO
    SSIPHOTIHSHOTSIRHCHO

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    Replies
    1. FT,
      Is it any wonder that the GOP has often been called "The Party of Stupid"?

      Year after year of broken promises related to ObamaCare!

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  11. Headline: Republicans take control of Titanic, Iceberg imminent!

    Republicans failed before they started because they proceeded from the failed premise that health care is a right provided by the government.

    Progressive Dems do an excellent job framing and freezing an issue.

    Also, unless they address the underlying dysfunction of the irrational, economic funhouse health care market, they are just playing shell games with billions and pushing costs around.

    I also don't like the tax cuts for rich people and the callous disregard for those who cannot afford medical care.

    The entire discussion is irrational. If Republicans pass this, they own the inevitable failure.

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    1. SF,
      Agreed!

      Republicans failed before they started because they proceeded from the failed premise that health care is a right provided by the government.

      Since when does the government provide -- that is, fund -- a right? Non sequitur!

      If Republicans pass this, they own the inevitable failure.

      Single payer in a few years. How few? Perhaps three, IMO. Why three years? The 2020 General Election!

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    2. Even California wasn't stupid enough to go "single payer".

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    3. No kidding!

      Americans do not want to sacrifice quality of care AND relatively speedy healthcare -- particularly the speed of healthcare for chronic conditions and elective surgeries.

      BTW, under single payer, debilitating pain is NOT considered a condition which requires emergency care. Example: a kidney stone, which typically isn't life-threatening -- never mind the resulting pain that incapacitates the sufferer.

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    4. It will be a loose single payer, essentially Medicaid (ugh!) for the hoi polloi.

      The Clintons, the Obamas , the political grandees, and the upper crust elites will be able to fund their own boutique health care.

      Congress will not outlaw that. No way.

      Ironically, that situation could end up driving down costs to where the middle class could largely pay for their own health care.

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  12. It is inevitable that older people, particularly between the ages of 50-64 will have to pay more for health insurance.

    Two reasons:

    1. People in that age group require more healthcare.

    2. Our aging population, with the result that we don't have enough low-risk insureds in the pool of insured.

    I fail to understand why "children" have been allowed to stay on their parents' policies until age 26. Wouldn't forcing those "children" out into the market have created a pool of low-risk insureds? I had to buy my own health insurance once I came of age. The premium was low -- and easy to pay although I worked only a few hours on Saturday mornings @ $5/hour.

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  13. When it comes to medical are, try to remember and take comfort in this:

    We are MORTAL. Every one of us is going to have to DIE soimeday. No doctor, no hospital, no system of government, no amount of money –– no matter how vast –– will be able to save us from eventual DEATH.


    And to that I say:

    IT WOULD BE FAR BETTER to DIE as SOON as POSSIBLE, if we truly ARE going to succumb to LEFTIST IDEOLOGY.

    There are many things worse than death. Living as a SLAVE to the STUPIDITY of a SELFISH, LAZY,ARROGANT, IGNORANT, CHICKEN-HEARTED, GOOD-FOR-NOTHING MAJORITY would be high on the list among them.

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