Healthcare going forward

[Kulindahr]

Obama promised healthcare but left it entirely to Congress to create something for his signature. Congress passes laws, the president enforces or executes them.

Or in this case, Congress proposes laws and the president lies about what's in them.

By the evidence, even if it passes he won't know what's in it.

 

[Kulindahr]

It seems Ted Cruz understands the problem with the three-phase approach:

Tom Price: Trump's health care promises will be true down the line

I fully agree if you have something that going to fulfil all Trump's promises and can get the 60 vote approval then put it on the table as one bill now. Otherwise, it just looks like your playing a shell game.

Whoa -- Cruz sounds intelligent! Nice to know at least on Republican knows what governing is about.

 

[Kulindahr]

How can I have any real expectations when, after decades of effort that began before I was even born (and I'm an old guy on Social Security), the best that could be come up with was ACA (a/k/a Obamacare) which was no more than a lukewarm semi-remedy which brought new insurance to only about one-half of the people who formerly didn't have it? Even more so when this effort is being controlled by a political party which has nothing but scorn for the "little people" who are working at "inferior" jobs? And, by a party that has deliberately stalled Medicaid expansion into many of the states they control.

Somehow, if they repeal and don't replace right away, I expect something maybe by 2052 or 2053, or maybe earlier if they can pass Health Savings Accounts and tax credits which of course do NOTHING for most people.

Nice turn of phrase there!

 

[KaraBulut]

...By the evidence, even if it passes he won't know what's in it.

That's not fair. He probably read the first 144 characters of the proposed Bill.

 

[smokeshadow]

Now the Donald is threatening congressional Republicans with their jobs if they don't pass Trumpcare

http://www.thenewcivilrightsmovemen...eats_if_they_don_t_pass_trumpcare_is_he_right

and

http://www.thenewcivilrightsmovemen..._come_after_you_if_you_vote_against_trumpcare

Reminds me of a Dynasty episode and a scene where Alexis threatened to fire the entire board of ColbyCo if they didn't do what she wanted. Trump has the same mind set without the flair or the shoulder pads. . .or the BRAINS

 

[gsdx]

^ Isn't that blackmail? Isn't that against the law? Can Trump seriously be that stupid?














Yes, yes, and yes.

 

[Stardreamer]

^ Isn't that blackmail? Isn't that against the law? Can Trump seriously be that stupid?














Yes, yes, and yes.

Not really, is simply threatening to use his political capital against them. The problem is how much political capital does he have after he has been flushing it down the toilet for 3 months? A president with an overall polls running down near 40% is not going to have a lot of political capital to use. His only real asset is the die hard fan base on the far right but even that is shrinking.

 

[rareboy]

No. He also has the fear factor to play.

He is such a vindictive bully that I can see him devoting his time to doing to them what he did to Hillary...trash talking about them so much that it would drive their voter support down the toilet and primary-ing them out of the race.

But he's going to have a much harder time in the Senate....and he may actually be counting on the Senate to drastically alter the legislation until it passes and looks pretty much like Obamacare...only this time with his name on it.

 

[TX-Beau]

...But he's going to have a much harder time in the Senate....and he may actually be counting on the Senate to drastically alter the legislation until it passes and looks pretty much like Obamacare...only this time with his name on it.

If that's what he's counting on such a bill will never make it back through the House.

 

[KaraBulut]

If that's what he's counting on such a bill will never make it back through the House.

Boehner called it in the HIMSS speech- there's too many factions in the healthcare argument for anything to come of this effort. There's also not enough leverage in things like earmarks to buy votes like there was when Obamacare was passed.

There's a group of Koch proxies like Ryan/Pence/Cornyn who have political debts to pay off to wealthy donors who want the tax on the ultraweathy repealed.

There's a group of Republicans who are under pressure from healthcare lobbying groups who don't want to return to the old system of uninsured people in their hospitals and emergency rooms (and who have invested millions in ACOs, population health and other ACA initiatives).

There's a group of libertarians like Rand Paul who don't want anything resembling government interference in "the free market".

And last of all, there's a group Republican congress members who have seen the fury from the town halls and know that there will an electorate backlash if they try to kick 20 million people off healthcare plans. With this group are Republican governors who will have to deal with the current Medicaid population who will lose coverage.

There's not Democratic votes to be peeled off- they're pretty dug in that they won't accept anything that reduces the number of insured people from the current numbers- whether it's via Medicaid expansion or the exchanges.

The longer they spend on healthcare and the more political capital they expend on something that the majority of people don't want, the less focus there is on the projects that the majority wants- tax reform, infrastructure projects and legislation to address middle class complaints. I don't know that I've ever seen a group of politicians who have managed to paint themselves into a corner this way.

 

[rareboy]

It is pretty delicious, isn't it?

Except for the wreckage that they could leave behind for the Dems to clear up again....it is delightful to see a majority Republican House and Senate and a wobbly president in this position.

They all fell right into the trap of a polemics and 'promise' driven agenda.

But their haste to 'git 'er done' may come back to badly decimate their ranks in 2018.

- - - Updated - - -

That's not fair. He probably read the first 144 characters of the proposed Bill.

 

[KaraBulut]

...But their haste to 'git 'er done' may come back to badly decimate their ranks in 2018.

Every time Paul Ryan comes out of these meetings and says that things are going great, uses some sports metaphor for Trump's efforts ("hit it out of the park!") and says that Obamacare is broken and has ruined the American healthcare system, I just feel like I'm watching Baghdad Bob.

 

[thewiz]

Every time Paul Ryan comes out of these meetings and says that things are going great, uses some sports metaphor for Trump's efforts ("hit it out of the park!") and says that Obamacare is broken and has ruined the American healthcare system, I just feel like I'm watching Baghdad Bob.

Except Baghdad Bob had more credibility than Ryan or Trump.

 

[Kulindahr]

^ Isn't that blackmail? Isn't that against the law? Can Trump seriously be that stupid?


Yes, yes, and yes.

Actually, maybe, no, and yes. As the (theoretical) leader of his party, he can use his clout to get members to fall in line. He's hardly the first U.S. President to do so, though he might be the first to be so crass about it.

 

[Kulindahr]

Now the Donald is threatening congressional Republicans with their jobs if they don't pass Trumpcare

http://www.thenewcivilrightsmovemen...eats_if_they_don_t_pass_trumpcare_is_he_right

and

http://www.thenewcivilrightsmovemen..._come_after_you_if_you_vote_against_trumpcare

Reminds me of a Dynasty episode and a scene where Alexis threatened to fire the entire board of ColbyCo if they didn't do what she wanted. Trump has the same mind set without the flair or the shoulder pads. . .or the BRAINS

If Obama had had the guts to do such a thing (with more class), we might have gotten a better version of the ACA -- like, requiring 89% of revenues to be spent on medical care, maybe.

 

[Kulindahr]

It amazes me that a supposed businessman doesn't look to enhance revenues. The simple bank transaction tax that's been repeatedly proposed could pay off the national debt in a few months, then fill the Social Security fund to a five trillion surplus, then pay for all the U.S. interstate and U.S. Highway systems to be made fully modern, then build fifty new medical schools....

In fact the G.O.P. should love such a solution to the Social Security system at least: it would allow the fund to be put in their "lock box" and taken out of the federal budget.

 

[offthewall14420]

When male model Scott whatever got elected after Teddy in MA, Pelosi said the senate ACA was unpassable.

But she and Clyburn whipped the votes and had enough cushion to let the blue dogs vote no.

Ryan doesn't have the same cushion, clout or 'institutional memory' to force his caucus.

POTUS is polling at 37%. I really expected him to get it out of the House and then die in the Senate. Hopefully he'll call a vote, lose, and resign.

 

[Benvolio]

They should let ACA fail first; it will be easier to pass a replacement and the democrats will not be able to blame the GOP by pretending ADA was better. ACA will fail because we cannot overcharge healthy people enough to pay for the preexisting illnesses.

 

[rareboy]

^ They all know that Obamacare wouldn't actually fail, particularly if they tweaked some of the things like creating larger risk pools through selling insurance across state lines.

If they allow it to fail...it still has their fingerprints on it.

 

[KaraBulut]

^ They all know that Obamacare wouldn't actually fail...

Exactly.

Congressional statements about the ACA present it as if it were only the individual marketplace. It's not- it's a very complex bill that aims to change the way that healthcare providers are paid and to provide a means for uninsured Americans to gain coverage. Most of the people who are getting insurance from the ACA are getting it through Medicaid, not the individual market.

Even if the individual market were to "fail" (whatever that means), the rest of the legislation- the part that pays providers based upon quality measures and outcomes, the Medicaid expansion, the minimum requirements for insurance plans and the restructuring of the way providers are paid would continue on.

On the other hand, if 24 million people suddenly lose their insurance when the bill is repealed, that's a PR nightmare.