Patterico's Pontifications

2/28/2017

ObamaCare Repeal Chaotic as Trump Writes Own Plan and Republicans Balk at GOP Plan

Filed under: General — Patterico @ 10:00 am

Well, nobody said ObamaCare repeal would be easy. But the main part of the problem is that not everyone agrees on the same principles.

First, we have two important Republicans saying that they reject a draft GOP plan to repeal ObamaCare, because it’s a GOP-approved Entitlement Lite package:

Two prominent House conservatives said Monday that they would vote against a draft of the Republican Obamacare repeal bill that was leaked last week, presenting a serious roadblock to the GOP’s increasingly complicated efforts to dismantle the Affordable Care Act.

. . . .

Meadows told CNN that what is unacceptable to him are the refundable tax credits included in the draft of the bill. Those tax credits, the North Carolina congressman said, are nothing short of an “entitlement program.”

“What is conservative about a new entitlement program and a new tax increase? And should that be the first thing that the President signs of significance that we sent to the new President?” Meadows said in an interview. “A new Republican president signs a new entitlement and a new tax increase as his first major piece of legislation? I don’t know how you support that — do you?”

So for these members of Congress, the problem is too much government involvement. Meanwhile our President, no fan of the free market himself, is planning to tackle the problem on his own. Hooray:

President Trump told governors at a meeting at the White House Monday that his administration will put forward its own ObamaCare replacement plan within a few weeks, according to two governors who attended the meeting.

. . . .

“The way I felt, I think Secretary [of Health and Human Services Tom] Price was going to be coming up with a plan,” Virginia Gov. Terry McAuliffe (D) told a small group of reporters on Monday after returning from the White House meeting.

“I felt that way, didn’t you, Brian? It was pretty clear,” McAuliffe said, referring to Nevada Gov. Brian Sandoval (R), who was standing next to him.

Sandoval then said “yes” and indicated the message was that the administration plan would be ready “within a few weeks.”

McAuliffe said Price, who was in the meeting, mentioned the plan would be ready in three weeks. Trump replied, “No, I want it in two,” according to McAuliffe.

A man of action! Who needs a third week when you have two? Make sure you summarize it in a one-page memo, Secretary Price. No more than nine bullet points.

I’m guessing Trump is not going to be as skeptical of government involvement as the aforementioned Congressmen. I rather suspect Trump will bring to the table his own unique combination of lazy, ill-researched, hastily arrived-at judgments, lack of attention to detail, and fondness for big government. Who here thinks the plan Tom Price comes up with will be a free market plan? Who thinks it will contain hard choices that may not all be politically palatable? Anyone? Bueller? Bueller?

Look. A free market approach is always the best approach to any problem, and so it is with health care. Utterly repealing ObamaCare root and branch is what must happen. Eliminate all subsidies, mandates, and requirements. Allow insurance companies to compete nationwide. Eliminate differential tax treatment of health care by employers.

People making their own choices is always best. Always.

There are valid issues with an immediate move to a more pure free market (which, by the way, we have not had in your lifetime, so don’t tell me the free market didn’t work, because we never tried it). Decades of government interference in health care have broken norms of charity care, and destroyed societal mechanisms for dealing with health care issues. There will have to be a transition period of three to four years for people who relied on the current system. You can’t remake this overnight.

What should be done is easy. What can be done politically — there’s the rub.

I’ve never seen an entitlement undone and I doubt we’ll see this one repealed. The word “entitlement” is especially accurate in American politics because people feel entitled. The public, in its infinite wisdom, wants to keep the parts of ObamaCare it likes (such as the ban on denying coverage due to pre-existing conditions) and jettison the parts it doesn’t like (such as the mandate). There are snake-oil salesmen who will make this sound possible. Looking at you, Donald Trump!

As with any thorny political problem, it is important to keep in mind Thomas Sowell’s dictum: there are no solutions, only trade-offs. The free market is not a panacea. It is not an instant ticket to utopia. Humanity will remain imperfect, and the mechanisms that a market develops to address a situation will not always fix every single problem. All we know is that it will be better than anything government can devise.

Your choice is clear: trust the market, or trust government. We’ll see which road the Republican Party heads down. I think I know which it will choose, and the answer ain’t pretty.

[Cross-posted at RedState and The Jury Talks Back.]

93 Responses to “ObamaCare Repeal Chaotic as Trump Writes Own Plan and Republicans Balk at GOP Plan”

  1. Utterly repealing ObamaCare root and branch is what must happen. Eliminate all subsidies, mandates, and requirements. Allow insurance companies to compete nationwide. Eliminate differential tax treatment of health care by employers.

    It’s worth pointing out that the last two problems predate ObamaCare, so “repealing ObamaCare root and branch” is just part of what must happen.

    CayleyGraph (353727)

  2. The problems with replacing the ACA are Trump’s fault. Congressional Republicans wanted to first eliminate ACA, with current plans running through 2017, and then work on a replacement. Trump demanded a new plan first. Without the stick / new status quo of no ACA, no Democrat will sign onto a replacement bill, and Republicans are divided on exactly what to replace it with.

    David Pittelli (0a4463)

  3. The problem is that some GOP govs expanded Medicaid for the poor to comply with Obamacare, and some states opted o not do so. Each circumstance requires a different response in order to unwind the system. But unwinding it in one fashion works to the disadvantage of the states in the other category. So you have a split among govs and a split among the GOP reps and senators in those two groups of states. Even as hiker said today that he doesn’t see 50 GOP votes for either of the two approaches.

    How is that now Trump’s failure?

    Shipwreckedcrew (1a3643)

  4. This was the maverick plan, I think its a perfectly reasonable element,

    narciso (d1f714)

  5. why do sleazy corrupt filthy trash like Ohio Governor John Kasich pretend there’s something noble about doing filthy government healthcare on your own citizens

    there’s nothing more digusting than being in a room full of people on medicaid

    they smell bad and they keep scratching at themselves like they got bugs

    happyfeet (28a91b)

  6. Well, nobody said ObamaCare repeal would be easy.

    The house voted to repeal obamacare 60+ times while Obama was president. Surely this wasn’t political grandstanding?

    Davethulhu (fab944)

  7. Time for Catholic and Baptist charities to get out of the refugee resettlement bidness and back to the great commission. It’s cheaper to make muslims here than to import them and QC seems a little better.

    Pinandpuller (16b0b5)

  8. Speaking of, don’t Muslims and Amish get to opt out of the ACA?

    Pinandpuller (16b0b5)

  9. Only the former, pin, there’s a whole set of spanners in the workd

    narciso (d1f714)

  10. “Who here thinks the plan Tom Price comes up with will be a free market plan?”

    Price authored the Empowering Patients First Act of 2015 which takes significant steps towards a free market, particularly in TITLE III—Interstate Market for Health Insurance. The TITLE III provisions match up with Trump’s ideas of a panacea so we can anticipate the provisions being included.

    The legislation proposed and passed will not establish a free market for health care. I’m unaware of any pol actually promising to do so – the shock when they don’t will be minimal.

    Rick Ballard (2d3a64)

  11. Speaking of, don’t Muslims and Amish get to opt out of the ACA?

    Muslims no, Amish yes. Also evangelicals if they’re part of a “Health Care Sharing Ministry”.

    Davethulhu (fab944)

  12. narciso @4 By maverick do you mean McCain’s 2008 plan? Which he didn’t understand and allowed Obama to nisrepresent it in a debate?

    Sammy Finkelman (8dcc71)

  13. Patterico:

    Well, nobody said ObamaCare repeal would be easy

    Trump said yesterday everybody said it was easy (which is not the case) but says he learned that it wasn’t, after talking to the Governors and so on, and rewriting the tax code is like a tiny little ant compared to replacing Obamacare.

    Sammy Finkelman (8dcc71)

  14. … and everyone knows an ant can’t move an insurance lobbyist plant!

    Colonel Haiku (ea7bff)

  15. People should have choices… don’t just work around the edges… make the transition as painless for the middle class as possible.

    Colonel Haiku (ea7bff)

  16. It’s easy to destroy things. Obamacare came in like a wrecking ball. It’s going to take real work to fix it.

    Trump has said everything and anything on what he will do–even dabbling and flirting with single payer. He’s almost sure to disappoint someone. He’ll try to blame whomever but it will be his head that rolls. Most of America think he sold them something and he will not escape.

    Rae Sremmurd (2fd998)

  17. Drudge sez massive innernetz outage is sweeping the east coast…

    Colonel Haiku (ea7bff)

  18. Patterico: (Trump’s imaginary order to Price)

    Make sure you summarize it in a one-page memo, Secretary Price. No more than nine bullet points.

    This actually could be done, but you are going to have to use the refundable tax credit, which actually should be calculated and done completely independent of the income tax system, and there should be no means testing and Medicaid should be abolished, or become a low cost option, in the process.

    2) And it should be funded by a new tax – not the border adjustment tax, but a carbon tax, not because anybody should believe in it but it is a consunmption tax. It could also be limited to carbon imports or just fuel, and it could also include a refund not related to health care. In fact that could be used to lower the minimum wage.

    3) There must be a doughnut hole, and a way for every person to fill the doughnut hole (HSA accounts, extra from other people, savings, including some retirement savings, small advance from the IRS against taxes, low interest medical credit card, larger advance against future Social Security benefits) which should not be allowed to get too big, and maybe have a lifetime out-of-pocket cap.

    4) And a much higher percentage than now of medical costs must be paid for at time of sale. Incentives for GP (Family Practice) fixed fee per patient per year. Medical school paid for and some other things up to the 85th percentile.

    5) No co-pay for unscheduled visits – the exact opposite of Obamacare, and a limit as to the percentage of visists a doctor can claim were unscheduled.

    6) A variety of standard insurance policies drawn up, plus it being legal to vary from them, with the differences between the aamounts charged to different individuals being mainly in the deductible, which can even go as high as $10 million, and people with a very high deductible, or any deductible above a limit, havibng their charges being paid for by the federal government, by auctioning off the excess payments in batches to re-insurance companies other than the underwriter.

    7) All the money to go into special HSA accounts. Some money disappears after one year and the rest after two (so that some people don’t hoard all of it) but can be put into medical care gift certifiates, which can be issued by doctors’ medical practices and hospitals but whose total amount outstanding per medical caregiver cannot be too high so there’s little risk of not being able to fulfill their obligations. The gift cards will be insured.

    8. Only two thirds of the medical amount everybody gets can be used for third party
    insurance.

    I can probably collapse that, and more, into 9 bullet points.

    Oh and also: Uninsured people NOT charged the highest prices but close to the lowest; low cost access to medical records (not 75 cents per page) and honest estimates – law borrowed from that about movers and home repair maybe, and/or prie insurance by a separate company.

    Sammy Finkelman (8dcc71)

  19. Patterico:

    I rather suspect Trump will bring to the table his own unique combination of lazy, ill-researched, hastily arrived-at judgments, lack of attention to detail, and fondness for big government. Who here thinks the plan Tom Price comes up with will be a free market plan?

    It’s probably going to be somewhat ill-researched, and very much like what Price was previously proposing (which was not good enough, and just dabbled around the edges) but may be better than the House plan.

    It will probably have a refundable tax credit (essential) but may be limited by differences by age -it probably will not solve the pre-existing conditions problem, and may still try to work too much through insurance companies.

    You’ve got to get things to the point where lab clinics, medical practices and hospitals are advertising by price – not only price of course – and people don’t have to research prices – prices are volunteered to them.

    Who thinks it will contain hard choices that may not all be politically palatable?

    It’s quite likely the math won’t add up, and/or somebody is going to be left holding the bag.

    Sammy Finkelman (8dcc71)

  20. Take what we spend now on Obamacare, Medicare, Medicaid, VA healthcare, and see what sort of free market catastrophic plan could be applied as universal healthcare for all citizens. Then have the market put together supplemental plans that fill the gap at the bottom. For Vets and the elderly, subsidize the supplemental plans. For the rest of us, and for industry, these supplemental plans would be pretty cheap, as long as they don’t include abortion, sex changes and pre-existing conditions in the same pool. The difficulty is keeping the free market in the catastrophic plans, or they will grow in scope (liberals will see to it), and they will rack up the pricing. Of course, after racking up the pricing, they will donate to Democrats to get them to expand the mandate. Huge slippery slope risk.

    Smarty (0bab40)

  21. 11: That a Dave Ramsey kind of thing?

    urbanleftbehind (c8adc7)

  22. Too bad we can’t make the Powell Doctrine stick in this–Democrats broke it, they own it.

    Although a lot of Trump fans are simply white Democrats that realized their party just wasn’t that into them. You can recognize the same dripping hate as rational that marks the Liberal “thought” process.

    Rae Sremmurd (2fd998)

  23. Patterico:

    The public, in its infinite wisdom, wants to keep the parts of ObamaCare it likes (such as the ban on denying coverage due to pre-existing conditions) and jettison the parts it doesn’t like (such as the mandate). There are snake-oil salesmen who will make this sound possible.

    It is possible. Replace the mandate with a version of a consumption tax.

    But price still has to matter. So don’t put people on Medicare, or Medicaid, or have them buy too much insurance but refund the tax and have them pay. If everybody is enrolled, or it osts nothing to enroll, you have no problem with pre-existing conditions.

    Looking at you, Donald Trump! I don’t think he’s that good. It can’t be snake oil.

    Sammy Finkelman (8dcc71)

  24. Designing Obamacare was easy. Its only goal was to eventually fail. The idea was: when it eventually failed, Democrats (with their emerging permanent majority) would have the White House, the House, and the Senate, so they could put in whatever the replacement would be (probably single-payer). They would just blame Republicans and the greedy healthcare/pharma-industrial complex, and steamroll us into single payer. You know every Democrat officeholder, from the far-left progressives to the “moderates” would crawl over broken glass to vote for single payer if Pelosi told them to.

    Fixing Obamacare is basically impossible. It was designed to fail. How do you fix something that is intended to destroy our system from within? How do you compromise with that? You can’t make nice with the Cloward-Piven strategy, you have to smash it.

    Repealing/replacing will not be easy either. This is a giant mess, by design. People were led to believe that they could have free shit, to the point where they now feel entitled to it. If we repeal Obamacare, some people will lose their healthcare, and they will be upset about it. But so what? Lots of other people lost their healthcare because of Obamacare, and the death spiral means that the current situation is not stable. Democrat politicians are evil. They knew this could happen, the ones at the top wanted it to happen. And now no matter what happens, they will put the blame on Republicans.

    Obamacare, a doubled national debt, a secret agreement that allows Iran to get nukes – Mr. Trump inherited a mess from Obama. He wasn’t the person I would have chosen to fix it. At least he seems to recognize what the problems are. We need to support him when he is fighting for us.

    Daryl Herbert (7be116)

  25. The Powell doctrine was a canard, saddam had broken the country, those that plagued the coalitions were his minions, and many became officers in the Islamic state ( read Kyle orton)

    narciso (d1f714)

  26. this amazon thing is really kinda scary

    happyfeet (28a91b)

  27. 6. Davethulhu (fab944) — 2/28/2017 @ 11:00 am

    The house voted to repeal obamacare 60+ times while Obama was president. Surely this wasn’t political grandstanding?

    Of course it was – and one time a bill actually passed Congress after the Republicans gained control of the Senate and was vetoed by Obama and the override failed.

    http://thehill.com/policy/healthcare/267963-house-fails-to-override-veto-of-obamacare-repeal

    You probably don’t remember this because it didn’t make big news because all the media and all the members of Congress knew it didn’t stand a chance of becoming law, nor would the bill have passed Congress if it did.

    Now they are saying well, this at least committed people to opposing Obamacare.

    Sammy Finkelman (8dcc71)

  28. 2. David Pittelli (0a4463) — 2/28/2017 @ 10:11 am

    The problems with replacing the ACA are Trump’s fault. Congressional Republicans wanted to first eliminate ACA, with current plans running through 2017, and then work on a replacement. Trump demanded a new plan first.

    Which is very logical, because otherwise a replacement might not pass. Without the stick / new status quo of no ACA, no Democrat will sign onto a replacement bill, and Republicans are divided on exactly what to replace it with. That’s a problem, but what they are doing is they are making Obamacare more fiscally unsound. It really won’t work for 2018.

    But Democrats still won’t go along easily. They’ll support, if anything, Medicare for all. Which destroys the economics of medicine even more. Prices rise, and eventually the government tries ti cut back on care.

    That’s one reason I mentioned the carbon tax.

    Sammy Finkelman (8dcc71)

  29. his own unique combination of lazy, ill-researched, hastily arrived-at judgments,

    I got that far, Patrick.

    I’ll drop by again in a few weeks.

    Mike K (f469ea)

  30. I’d like to see Warren Beatty present the Price Waterhouse plan.

    Pinandpuller (16b0b5)

  31. That is not an argument, Mike K.

    I miss the Mike K who made arguments. For example: “I don’t think Trump has engaged in lazy, ill-researched, hastily arrived-at judgments because…” The guy who just drops by to chide me if I ever criticize Trump, I don’t miss at all.

    If you really had come by to see what things are like, you would have seen at least three posts praising Trump and zero criticizing him before today, going back as far as February 19. But you didn’t really come back to be fair or make arguments. Just to whine about literally any criticism of Trump, even if you can’t be bothered to even try to refute it.

    Tiresome. Boring. Not worth my time.

    I’ll see if your comments become more valuable in a few weeks. Or you can flounce, again, which as you can tell would distress me greatly. Anyway I won’t believe a flounce because it’s happened before and you like to whine too much. You’ll be back to make the same pointless comment again. Expect the same pushback I just gave you. Or stay away for good, or at least until you have something to offer besides the same tiresome whine, which I realize may be never.

    Anyone who agrees with him is also welcome to leave. The guy who insists on coming by to tell you your blog is no good is the most tiresome person on the planet. May all such people become offended and never return until they can find something else to say.

    Patterico (fe2a1f)

  32. Nothing would please me more than a mass flounce in response to that comment. But please mean it. Make it a point of personal pride and stubbornness if that helps.

    Patterico (fe2a1f)

  33. 29. Hopefully Annette Bening isn’t like Catherine Zeta Jones in one medical regard.

    urbanleftbehind (c8adc7)

  34. Well lets not go there, pin, then again whatever his film that came and gone.

    narciso (d1f714)

  35. I honestly think people may not realize how fundamentally rude it is to swing by and just express a general displeasure rather than a specific and reasoned argument in response.

    There is a difference between “I think your comment or post is wrong and here’s why” and “I see you are still generally deranged on topic x but I won’t bother to argue why I think you’re wrong.”

    If you can’t see the difference, you need to work on telling the difference. I mean this to everyone.

    Patterico (fe2a1f)

  36. Allow insurance companies to compete nationwide.

    I don’t understand what this means. Lots of big medical insurers currently operate across state lines, they just have to comply with state insurance law in each state.

    Roscoe (d9df47)

  37. The Powell doctrine was a canard, saddam had broken the country

    +++++++

    True, although I’m not sure we knew just how damaged it was. I think that was some of the argument behind not using as much air bombing IIRC

    Rae Sremmurd (2fd998)

  38. I don’t know maybe some of the true blue Trump supporters can tell us what they think Donald’s prescription for ObamaCare is–in their own words.

    Understandable that they might be frustrated with that and lash out.

    Rae Sremmurd (2fd998)

  39. OT — interesting column out speculating that it might have been the Brits who provided the transcript of Flynn phone calls with the Russians, and fed the transcript to the FBI while Obama was still in office. That would have avoided the FISA restrictions on intercepting US citizens and/or redacting identifying information for US citizens caught up in a FISA wiretap.

    Head of Britain’s equivalent of the NSA abruptly resigned without explanation on Jan. 23. Trump had a meeting scheduled with Brit PM on 1/27, but at the point he came into office on 1/20, he would have been in a position to demand to know what evid the FBI had on Flynn, and where it came from.

    If the Brit disclosure hadn’t been authorized by the PM, she might have simply told the guy “You have to go before I meet with Trump.”

    shipwreckedcrew (56b591)

  40. What would be the Brit endgame? To smear UKIP and Co. as Russian stooges and rationalize a screeching halt of Brexit proceedings?

    urbanleftbehind (c8adc7)

  41. Senator Lee might be right here. Rip it out like a band aide–the faster the better.

    http://www.washingtonexaminer.com/mike-lee-to-gop-repeal-obamacare-now-dont-fear-the-boogeyman/article/2615114

    Rae Sremmurd (2fd998)

  42. Just repeal the darn thing and allow people to buy plans across state lines. Competition will allow people to get what they want as long as they aren’t deathly ill.

    For those… just give them Medicaid since you won’t repeal it anyway.

    NJRob (e9cb75)

  43. Get rid of it but have a plan! That’s not unreasonable.

    Colonel Haiku (ea7bff)

  44. 38.OT `shipwreckedcrew (56b591) — 2/28/2017 @ 1:41 pm

    — interesting column out speculating that it might have been the Brits who provided the transcript of Flynn phone calls with the Russians, and fed the transcript to the FBI while Obama was still in office. That would have avoided the FISA restrictions on intercepting US citizens and/or redacting identifying information for US citizens caught up in a FISA wiretap.

    Head of Britain’s equivalent of the NSA abruptly resigned without explanation on Jan. 23. Trump had a meeting scheduled with Brit PM on 1/27, but at the point he came into office on 1/20, he would have been in a position to demand to know what evid the FBI had on Flynn, and where it came from.

    No, no no. Why would the Brits be wiretapping in Washington? The US wouldn’t like that. Adnd there’s no legal reasons for that. Now mayhbe it could have been shared with the British

    Head of Britain’s equivalent of the NSA abruptly resigning – is that right? – would more likely have something to do with the dossier on Trump thst Christopher Steele collected. Maybe he was circulating it.

    Sammy Finkelman (6f9f42)

  45. I’m guessing Trump is not going to be as skeptical of government involvement as the aforementioned Congressmen. I rather suspect Trump will bring to the table his own unique combination of lazy, ill-researched, hastily arrived-at judgments, lack of attention to detail, and fondness for big government.

    Is this a quote lifted from a post from a year ago?

    Jerryskids (3308c1)

  46. Might be easier for Senator Lee to say this from Utah however. He just was re-elected and the Democrats ran a tranny against him. No joke.

    Rae Sremmurd (2fd998)

  47. Roscoe (d9df47) — 2/28/2017 @ 1:06 pm

    Lots of big medical insurers currently operate across state lines, they just have to comply with state insurance law in each state.

    i think the idea is maybe that they wouldn’t.

    This doesn’t solve anything. And then you could argue ther could be arace to the bottom Like with usury rates for credit cards.

    Sammy Finkelman (6f9f42)

  48. Sammy – Agreed it would be a terrible idea. I could give you a number of reasons why medical costs are out of control (and one real big reason) but state regulation isn’t one of them. And it pisses me off when people who call themselves conservatives are all about federalism, until suddenly they aren’t.

    Roscoe (d9df47)

  49. A to the MEN for your OP and your posts in the comments section, Pat.

    One thing little discussed is the very likely consolidation to even fewer insurance providers if the state-by-state governance of insurance is eliminated. At first, there may be a slew of new folks offering plans. However, given the enormity of Anthem and Kaiser and such, it would be a matter of time before they priced everyone out.

    Most any private solution beats the living feces out of government healthcare.

    One other aspect of all this which is hinted at by Pat is the political fracture which is sure to occur if DJT does not rip ACA out by the roots. The GOPe simply does not understand that the peril to them if they half-ass this is exponentially greater than if they do mostly right things (free market concepts) and anger the Statists.

    I am on long record that McConnell and Ryan would run rings around The Donald. I see Reince as a GOPe fox in the DJT hen (White) house.

    I’ll be quite happy to be proven wrong.

    Ed from SFV (3400a5)

  50. I’m hoping they can work as a team, Ed, and quash the egos (one in particular)! I think you are right in what you’ve stated. This is much too yuge and critical an issue to do a half-assed job on it. Time to put up or shut up, and it had better not be the latter.

    Colonel Haiku (ea7bff)

  51. I see Reince as a GOPe fox in the DJT hen (White) house

    ++++++++++

    How did the Donald God let himself get played like that?

    Rae Sremmurd (2fd998)

  52. Everybody wiretaps everybody, ghcq which evolved from the touring project

    narciso (d1f714)

  53. I heard President Trump talking about Obamacare the other day. He sounded very Bannon-like; I was pleased. This Bannon character has given the President the ideological rudder he seemed to lack. I couldn’t have hoped for more.

    It seems to me that the obstacle to complete repeal will be all the RINOs in the Republican caucus and not President Trump. So the “GOP” bill (wouldn’t “GOPe” be more appropriate?) is being trashed by conservatives? No surprise there. And no surprise that there is a large contingent of RINOs who want to jump on board. Sadly, most Republican elected officials see their job as pimping, plain and simple. They turn my stomach; I’d really like to see them shamed. Cleaning up the moral wasteland that is our congressional caucus seems like the kind of work President Trump is cut out for. He is doing it to the media. Why not RINOs?

    I’ll be interested to see if the President chooses to stand tall and demand full repeal or if he negotiates with the RINOs. Although I’d prefer he’d stand tall, my guess is that if he negotiates, he will get the better end of the negotiation. One thing we know about President Trump, he can negotiate; one thing we know about the RINOs, they can’t.

    ThOR (c9324e)

  54. There’s a delightful headline over at HotAir: “Governors to Trump: Chill out on the weed.”

    It is nice to finally have a President who doesn’t “chill out on” the law. Why do so few pols, including Republicans, fail to understand that the law matters?

    ThOR (c9324e)

  55. I’m guessing Trump is not going to be as skeptical of government involvement as the aforementioned Congressmen. I rather suspect Trump will bring to the table his own unique combination of lazy, ill-researched, hastily arrived-at judgments, lack of attention to detail, and fondness for big government.

    During the campaign, Trump promised a health care plan that would make everything perfect for everyone, “at a tiny fraction of the cost” of Obamacare.

    “You’re going to have such great healthcare at a tiny fraction of the cost, and it is going to be so easy.” – Donald Trump, October 25, 2016

    You might have thought, since he was promising it, that maybe he had some idea what the plan would, you know, actually involve. But no. It was just going to happen magically, thanks to rainbows and unicorns. Kind of like two or three decades worth of lost manufacturing jobs reappearing, or Mexico paying for his wall.

    Trump, of course, is a drooling moron, and says idiotic things constantly. But how dumb do you have to be to actually believe a con-man who’s so obviously full of sh*t?

    Dave (711345)

  56. Urbanleftbehind

    Gary Cooper and several other big stars died young. I’m thinking of asbestos laden women’s underpants.

    Pinandpuller (7eaf94)

  57. It is nice to finally have a President who doesn’t “chill out on” the law. Why do so few pols, including Republicans, fail to understand that the law matters?

    ThOR

    Personally, I agree with Trump’s view that marijuana should be criminalized, but Trump explained before that he wanted this to be a state to state issue, and by flip flopping so suddenly, he comes across as erratic, and as a president who does not understand the federalize principles he often quoted (from others) or the basic concepts of conservatism. While I do not want recreational marijuana to be legal, I really did like Trump’s initial approach, which was to let states decide these sorts of matters. I would like to know why Trump changed his mind on this.

    When you describe disagreement with Trump as a personal failure, it sounds like you’re refusing to listen to the other side on these issues, which isn’t surprising as Trump’s supporters continue to circle the wagons on everything. But do you understand federalism and the argument for the feds to butt out of a lot of matters that each state can decide? It was a major aspect to how this country was initially founded. One of the reasons Trump and Obama and Bush took so much flack was that it’s so frustrating for an intellectually diverse nation to be ruled by a central and powerful government. This need for a policy powerful federal government is unconservative and I think ineffective.

    Dustin (ba94b2)

  58. Trump, of course, is a drooling moron, and says idiotic things constantly. But how dumb do you have to be to actually believe a con-man who’s so obviously full of sh*t?

    Aside from the obvious fact that your bullsh*t is wearing thin and getting infantile and tedious, you seem to refuse to take Trump seriously but insist we take Trump literally.

    Rev. Hoagie® (785e38)

  59. marijuana’s not an issue for me

    i don’t really care about that whole milieu

    it should be either illegal or legal

    but not in-between

    happyfeet (28a91b)

  60. So now we are getting broad hints on Fox News of DJT bending his immigration promises to fashion a “comprehensive immigration bill” which can be passed. Color me not shocked.

    Ed from SFV (3400a5)

  61. Hoagie,

    However thin you find Dave’s argument, his quote is pretty damning:

    “You’re going to have such great healthcare at a tiny fraction of the cost, and it is going to be so easy.” – Donald Trump, October 25, 2016

    This, like his ‘ISIS will be destroyed in the first 30 days’ promises, were lies. Trump is the politician who just completely abandoned truth to simply hustle the American people. Other politicians lie, but not like this. Trump promises the absurd, with no specifics, and his fans say this is the ‘art of the deal’ as though they wanted to be hustled.

    What do you think Trump’s healthcare plan is, do you think it’s going to “so easy”? and how is it going to be a tiny fraction of the current cost? This is a promise to everyday Americans. I am not clear on your issue with taking Trump literally. Do you think he was lying to us when he made these promises? Do you think he really thought such grand claims were possible?

    Dustin (ba94b2)

  62. I’m not convinced it is Trump who is confused about federalism or that this is a flip-flop. I see no contradiction between enforcing the federal law, as written, and believing that marijuana laws are better left to the states. Unless and until the federal law is repealed, it is President Trump’s job to enforce it. My belief in the preeminence of federal law isn’t clouded by my support for federalism. Federalism doesn’t mean that Presidents should abdicate their duties – though I guess you disagree – but that the federal government needs to stop passing legislation that commandeers states’ prerogative. I believe this is precisely the goal of Bannon, by the way.

    For some reason, it has become the common view that federal law enforcement should be at the whim of the President. Sorry, but I don’t share that view. And neither does Bannon. That’s what his “deconstruct the administrative state” comment was all about.

    Finally, from a strategic perspective, what better way to drum up support for decriminalizing marijuana laws at the federal level than to enforce the ill-conceived laws written by congress and signed into law by some former President? If these governors are unhappy with Trump’s enforcement, they should have a word with the state’s congressional delegation about repeal and not with the President about enforcement. One of my biggest gripes with congress is its willingness to pass laws that they don’t want to see enforced and an executive who is willing to accommodate them. I’m horrified that these elected officials are so un-serious about their duties. I’d like to see President Trump ram these laws down their collective throats.

    ThOR (c9324e)

  63. The repeal of the ACA is a lot like the old yank the tablecloth off the table trick that hardly ever failed to scatter the placesettings.

    Pinandpuller (7eaf94)

  64. Well robertscare was designed to destroy the current system, that has been testified to by many of the architects.

    narciso (d1f714)

  65. Rae

    ACA RX: Mozambique Drill in the middle of 5th Ave.

    Pinandpuller (7eaf94)

  66. ACA kidnapped America

    Tear the duct tape off?

    Pull the duct tape off slowly?

    Asphyxiate?

    Pinandpuller (7eaf94)

  67. Stockholm Syndrome?

    Colonel Haiku (2601c0)

  68. Finally, from a strategic perspective, what better way to drum up support for decriminalizing marijuana laws at the federal level than to enforce the ill-conceived laws written by congress and signed into law by some former President?

    Well, Trump isn’t saying he sees these laws as ill-conceived. He supports criminalization. He’s simply reversed his view.

    I’m not convinced it is Trump who is confused about federalism or that this is a flip-flop. I see no contradiction between enforcing the federal law, as written, and believing that marijuana laws are better left to the states.

    The contradiction is that Trump has advocated keeping these laws AND enforcing them. Of course if he were fighting to repeal criminalization because of his federalist promises during the campaign, but said that until he can get congress to play along, he will enforce the laws on the books, that would be an admirable act of integrity to his oath. But this contradicts Trump saying he agrees with criminalization on a federal level (which again contradicts Trump saying he will leave the issue to the states).

    I think you’ve raised a very intelligent distinction between the roles of the branches, but Trump simply does not appear to care about his ‘let the states do what they want’ views in the campaign. He was cynically catering to a bloc of voters by telling marijuana consumers what they wanted to hear. It was the Art of the Deal, and Trump’s promises when running for president were simply insincere.

    I support criminalization of marijuana as a concept, but do not think the federal government has to be involved in the decision and I don’t mind different states trying different approaches. That’s one great thing about Trump… I think because he’s already very unpopular that a lot of Americans are open to the idea that we can’t trust the other states to provide us with good federal candidates or winners. If Texas alone was picking our president, hey we’d have Ted Cruz and things would be so much better.

    Dustin (ba94b2)

  69. Is it easier to buy guns across state lines than insurance? If Hillary were in I’d know for sure because we would never stop hearing about it.

    Pinandpuller (7eaf94)

  70. ACA kidnapped America

    Tear the duct tape off?

    Pull the duct tape off slowly?

    Asphyxiate?

    Pinandpuller

    Tear the duct tape off.

    Just get rid of the whole thing.

    Maybe replace with nothing.

    The worst you can do is like Obama and simply not enforce the painful penalty part, while keeping the rest of the law.

    Dustin (ba94b2)

  71. “It ain’t fair, John Sinclair
    In the stir for breathing air
    Won’t you care for John Sinclair?
    In the stir for breathing air.
    They gave ‘im ten for two
    What else could the bastards do.”

    Colonel Haiku (2601c0)

  72. This is the problem, robertscare reformatted all the previous plans, it wAs rube Goldberg designed by doctor evil.

    narciso (d1f714)

  73. No more Hillary! PandP, but the media are working hard to make Chelsea a star. Just imagine Hillary! without the social skills and her level of spontaneity and you’ve got daughter Chelsea.

    Colonel Haiku (2601c0)

  74. Also – some things ought to be just covered flat – probably by Medicare – like kidney dialysis is. Treatment for infectiotus diseases and drug treatment – if it works! might be handled that way. You could determine what works by the amount of Social Security taxes paid over the course of the next year by people who have been through the treatment or are being treated., adjusted maybe slightly according to previous work history.

    Sammy Finkelman (8dcc71)

  75. No more Hillary! PandP, but the media are working hard to make Chelsea a star. Just imagine Hillary! without the social skills and her level of spontaneity and you’ve got daughter Chelsea.

    Colonel Haiku

    Oh the election happened a few months ago so you can stop campaigning for Hillary in an effort to avoid talking about Trump’s clear promises.

    “You’re going to have such great healthcare at a tiny fraction of the cost, and it is going to be so easy.” – Donald Trump, October 25, 2016

    When do you Republicans keep your damn promises?

    BTW you’re still a racist piece of crap, Haiku.

    Dustin (ba94b2)

  76. Rave on, kitteh.

    Colonel Haiku (2601c0)

  77. Also – some things ought to be just covered flat – probably by Medicare – like kidney dialysis is. Treatment for infectiotus diseases and drug treatment – if it works! might be handled that way. You could determine what works by the amount of Social Security taxes paid over the course of the next year by people who have been through the treatment or are being treated., adjusted maybe slightly according to previous work history.

    Sammy Finkelman

    I think litigation reform would be a better approach. The real issue is controlling costs, right? But we want medical research and good medical treatment to be profitable enough to drive us forward into new treatments and cures.

    Tort reform, caps on damages, and other reforms directed at eliminating redundant or unnecessary treatments, would reduce costs.

    Free healthcare safety nets of some kind are probably inevitable, but I don’t think that’s going to make the real difference we need.

    Dustin (ba94b2)

  78. Rave on, kitteh.

    Colonel Haiku

    I intend to, because I deeply enjoy pointing out you are a racist. Of course your friends who are alt-righty are cheering you on. Other Trump fans are really uncomfortable about it because they aren’t quite sure what I’m ranting about (until I explain it to them… at which time they seem to stop involving themselves).

    So long as everyone knows you, a Trump fan, are a racist, I’m pleased.

    Of course, if you wanted, you could answer my very simple questions and then maybe even take responsibility, but have you ever directly answered any question I’ve asked you? All those debates about Romney or Trump and it seems I was always answering your points and you didn’t return the respect. I guess because of the racism, right?

    Dustin (ba94b2)

  79. Dustin (ba94b2) — 2/28/2017 @ 5:10 pm

    The worst you can do is like Obama and simply not enforce the painful penalty part, while keeping the rest of the law.

    That’s only bad for the federal deficit, or the insurance companies, or people who would like to buy individual policies, but people with pre-existing conditions are taken care of. Just repealing it is worse.

    If they simply do not enforce the painful penalty part, well, at some point, Democrats will have to face the fact that this is not working. Of course this could turn out like the sequester, which did not force Congress to do something. But it’s abetter status quo that just repealing it.

    Sammy Finkelman (8dcc71)

  80. Republicans have failed the people. 7+ years is enough time to fine tune an acceptable health care plan.
    “one who in a perilous emergency thinks with his legs”[Ambrose Bierce]

    mg (31009b)

  81. Remember venkmans line in ghostbusters ‘they don’t build them like that abymore’ to which egon replies, ‘they never did’ it is overpriced, and underserves its putative goal

    narciso (d1f714)

  82. His amnesty proposals tonight should provide some decent fog to cover the fact he can’t buy a clue on ACA – or any other actual policy issue.

    Rick Ballard (2d3a64)

  83. Dustin (ba94b2) — 2/28/2017 @ 5:25 pm

    I think litigation reform would be a better approach. The real issue is controlling costs, right?

    Controlling costs, without lowering quality, or seeing the institution of rationing.

    Litigation is a minor factor probably.

    But we want medical research

    Real, real, medical research is already not profitable. Some is funded by the goverment or philanthropy but then runs into the “valley of death” where treatments cannot get approved by the FDA because it is worth nobody’s while to finance it. Not to mention that many drug trials are really unethical because the researchers have no true doubts.

    Finding more antibiotics is just totally impossible. Even allowing pharmaceutical companies to charge astronomical prices will not work. A good idea would be buying up patents or offering to buy up anything that will do certain things.

    and good medical treatment to be profitable enough to drive us forward into new treatments and cures.

    The whole drug and medical device research system is not working. That is something that also needs to be changed. I don’t believe “right to try” legislation will be enough because 1) this is limited to what has already made it most of the way through the process 2) companies will not want to jeopardize approval.

    Appointing different people to the FDA would help, but I am not sure Mike Pence or anyone close to Donald Trump knows enough about this.

    Medical research now too, is not a free for all. Compounds like vitamins that can’t be patented are not worth anybody’s effort. Vitamins can be advertised for prevention but not for cure, but some can cure certain conditions but this can only be told by someone not selling them, and even they are somewhat afraid to suggest, for instance, non-surgical cures for cataracts.

    Companies nowadays get approval for one indication and rely on doctors to discuss others. ONce something is approved, it can be used for anything They also deliberately do not get approval for long expiration dates. That means much costly medicine is thrown out.

    And only the discoverer of a compound can research it. Fortunately a lot of similar compounds tend to work about the same, so each company can try a different thing.

    Tort reform, caps on damages, and other reforms directed at eliminating redundant or unnecessary treatments, would reduce costs.

    That’s not the problem. The problem is that somebody else is paying for it

    Free healthcare safety nets of some kind are probably inevitable, but I don’t think that’s going to make the real difference we need.

    The safety net is not for cost. The problem is devsing asafety net that does not drive up costs.

    Sammy Finkelman (8dcc71)

  84. 79. mg (31009b) — 2/28/2017 @ 5:30 pm

    Republicans have failed the people. 7+ years is enough time to fine tune an acceptable health care plan.

    They never tried, although some individual Republicans tried. some just came up with half measures.

    The first thing we have to recognize abut health care us, right now, there is no market. And you also can’t even give everybody the same amount of money to spend because needs are different. You need something complicated, with lots of checks and balances.

    Sammy Finkelman (8dcc71)

  85. One way to tell that there is no market: Proces vary by a multiple of six from the lowest tpthe highest cost provider.

    Even the cheapest provider is overpriced.

    Sammy Finkelman (8dcc71)

  86. Trump does not have the handicap with regard to healthcare of having promised something foolish.

    Sammy Finkelman (8dcc71)

  87. 19 year old girl with her first car just asked me if insurance covered brake pads and she was indignant with my answer.

    SMH

    Pinandpuller (7eaf94)

  88. Speaking of fine Columbian, it’s like Hey 19 just rolled off the factory floor, shiny and new like a virgin.

    Pinandpuller (7eaf94)

  89. 19 year old girl with her first car just asked me if insurance covered brake pads and she was indignant with my answer.

    SMH

    Pinandpuller (7eaf94) — 2/28/2017 @ 6:02 pm

    In her foolish mind the only insurance she’s ever dealt with was mommy and daddy’s health insurance. Since that covers checkups and her birth control, she thinks that’s the way insurance works.

    Stupid and will likely reproduce all too soon.

    NJRob (43d957)

  90. There are any number of prepaid vehicle maintenance plans, some that come “free” with a car purchase, and your brake pads better be covered by your new car warranty for defects including excessive wear.

    nk (dbc370)

  91. President Trump gave his Obamacare replacement outlines, after first saying it was a disaster and giving some reasons why it was, and citing Arizona and Kentucky.

    First problem: He doesn’t realize the problem is insurance itself or too much insurance.

    Of course people may need to be given money, but they should be making many of the actual spending decisions.

    This is an outline of his priciples:

    1) Coverage and access (that is, afforable access) for people with pre-existing conditions continues.

    2) Smooth tranistion from Obamacare.

    3) Tax credits (this is best done outside the income tax system, and deposited in advance. The amount should be enough to pay for some basic medical care, and a basic insurance policy, and the some of the money should also expire if not used, but maybe could be transferred to gift certificates. This is where I said there should be a doughnut hole. Standard tax credits will only be of worth to people with good management of their finances and some extra money or credit cards.)

    4) More use of health Savigs accounts. (good idea but this is just thrown in here as an extra)

    5) Insurance policies like you want, not as manadated by the federal government.

    6) State governments get more freedom to deal with the poorest people. Problem: in some states +wasteful spending is ingrained, for instance in nursing homes or the practice of using ambulances for doctor;s visits. Rather than pay nursing homes I would say money should be given to the patient or family to use as they want, and any tax complications handled by the state. And any misspeding can only be corrected at the grass roots level.

    Second problem: The money for medicaid might be too low, or become too low with time.

    7) Legal reform

    8. Lower artificially high cost of drugs. Problem: That’s really the result of government policy, or patents. What’s more these enormously high prices compensate for cost of drug eguulation.

    9) Sell insurance acriss state lines – i.e. South Dakota regulators would regulate some insurance sold in Wisconsin. Problem: Race to the bottom, and maybe some very bad policies, like ones with maximum limits which really don’t make sense, and people may not understand. That’s anti-catastrophic.

    Sammy Finkelman (8dcc71)

  92. @89 nk

    I go for lifetime brake pads at Autozone. They only give you three sets before it starts over so it’s like a guy with a life sentence getting seven years, which makes about as much sense.

    Most people who know better think that you pay for oil changes and check ups out of pocket and catastrophic repairs go on insurance.

    Pinandpuller (f98a4a)

  93. “28. his own unique combination of lazy, ill-researched, hastily arrived-at judgments,

    I got that far, Patrick.
    I’ll drop by again in a few weeks.
    Mike K”

    Why a few weeks? You think anything is going to change here?
    As if!

    —————–
    “34. I honestly think people may not realize how fundamentally rude it is to swing by and just express a general displeasure rather than a specific and reasoned argument in response.”

    What is a reasoned argument to make in response to “He is a poopyhead and smells of elderberries”?

    fred-2 (ce04f3)


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