Patterico's Pontifications

3/21/2017

TrumpCare Still Sucks

Filed under: General — Patterico @ 9:30 am



Donald Trump heads to Capitol Hill today to push the passage of a health care bill he doesn’t understand: TrumpCare, which rejects the free market, tinkers around the edges of the problem, and assumes that government central planning is the answer. This bill continues to treat insurance as the primary way to get health care, substitutes lawmakers’ judgments for that of the market as to how to price policies, and sustains an unsustainable path of central planning.

Basically, the First Five Year Health Care Plan has been determined a failure, so Trump will give us a Second Five Year Health Care Plan. Let’s hope it doesn’t take thirteen Five Year Health Care Plans to figure out that central planning of the economy never works.

Economist Bob Murphy suggests an analogy to food, to illustrate how ObamaCare (the First Five Year Health Care Plan) rejects the free market to the detriment of health care consumers. Let’s say the nation decided to deal with the problem of the hungry by saying that everyone had to buy a food plan. If you couldn’t afford it (or might have to give up your iPhone to buy it) the government would subsidize it. The food plan provided that you could go in the store and get whatever you wanted. Pretty soon you’d have shortages of everything, as people ran in to stock up on stuff. The price of food would skyrocket and the “need” for government to subsidize food plans would seem more critical every year.

This seems absurd to us, because we have experienced a (mostly) free market in food. But what if this experiment with food plans had begun decades ago? What if virtually nobody alive remembered what it was like to have a free market in food? If someone like me came along and said: “Dude! I found your problem! It’s these food plans! You just need to have a free market in food!” I would be derided as an ivory-tower egghead. Food isn’t like other commodities! I’d be told. It’s not a luxury item. You need food to live. People aren’t going to give up their free food. And what? You want millions to starve?

And if some narcissistic blow-dried ignoramus came along and told us that the Magic Solution was to institute a New Five Year Food Plan, I’d keep telling everyone the same thing: “We have to have a free market in food. Free markets are the only way you’ll get the costs down. I know you don’t understand this because you’ve had food plans your whole life. But empty shelves and lining up for hours for cheese isn’t normal. There’s a better way!”

Well, there’s a better way for health care, too. In any area not covered by insurance (like LASIK), prices have come down and quality has gone up. Having a third-party payer system, which has arisen because of government distortions in the market, will keep prices high — and subsidies, whether you call them subsidies or “refundable tax credits,” will only make it worse.

Freedom. The market. These are the mechanisms that will drive down the cost of health care and make it affordable. Tinkering with different ways to redistribute the wealth won’t work. It never has and it never will.

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

173 Responses to “TrumpCare Still Sucks”

  1. Donald Trump heads to Capitol Hill today to push the passage of a health care bill he doesn’t understand:

    I think that’s true: He doesn’t understand it. (with the caveat that he thinks it will be amended in a way so as get rid of all the bad points he admits.)

    Sammy Finkelman (3ea6b3)

  2. Chamber of Commerce Care
    is a kick in the gonads. wtf republicans in congress?

    mg (31009b)

  3. check out Kimberlin on Daily Caller

    EPWJ (0b2c7d)

  4. I’d really like to hear what people who are not covered by a public employee “Cadillac” plan or by their employer think of this and/or what’s needed. The folks who have skin in the game…

    Colonel Haiku (de797c)

  5. Freedom. The market. These are the mechanisms that will drive down the cost of health care and make it affordable.

    Except it doesn’t. The primary objective of the healthcare system in the United States is to make money, not deliver affordable healthcare to the citizenry. Once that mind set is shifted, the U.S. will adopt a single-payer/two-tiered system and join the 21st century.

    DCSCA (797bc0)

  6. @4. Colonel, my attorney sis-in-law has a public employee plan through San Diego County so damned good both her kids were literally born for free and her husband, a family law attorney, is covered under it as well. It’s just incredible. The only way they could top it is if they married their cars for the insurance coverage.

    “You’re in good hands with Allstate.” – ad tag

    DCSCA (797bc0)

  7. This is a very good post. I’m using your analogy, Patterico.

    felipe (b5e0f4)

  8. ” The primary objective of the healthcare system in the United States is to make money, not …”

    Let me change that to:

    “Except it doesn’t. The primary objective of any business system in the United States is to make money, not satisfying a need.”

    You can say that about anything and still be just as wrong. Lasik is just one example. But hey, live in your own world, truth be damned.

    felipe (b5e0f4)

  9. this is all pervy Mitt Romney’s slicked-up boy toy Paul Ryan’s fault

    he should be held accountable

    happyfeet (a037ad)

  10. @8. Changing the post to try to win is to lose.

    DCSCA (797bc0)

  11. ConservaCare, RyanCare… it’s D.O.A.

    DCSCA (797bc0)

  12. it’s a crappy bill that’s why everyone hates it

    happyfeet (a037ad)

  13. =yawn= You can grow your own tomatoes but you can’t remove your own appendix.

    DCSCA (797bc0)

  14. We’re resorting to government healthcare only because the free market has not worked. Far too many people can not afford to pay a hospital bill, if they’re hospitalized for more than a day or two anyway. By the way, food doesn’t pop up, without notice one day and charge you $100,000 or more to save your life.

    I doubt the premise anyway. For capitalism to work in a market, a level playing field is a must. That is not the case with medicine. For one thing, the market is more of an oligarchy. There is very little competition in medicine, or the prices would be much more reasonable.

    It’s not as if someone who thought government was a panacea dreamed up government healthcare. The government wasn’t asked to fix this until after it became a problem.

    Tillman (a95660)

  15. It’s a lousy bill. I think we’re all mostly in agreement.

    NJRob (43d957)

  16. @14. Well said.

    DCSCA (797bc0)

  17. Thank you DCSCA.

    Tillman (a95660)

  18. As I understand it, Trump intends to proceed toward free market solutions in a series of incremental steps which only require a majority vote in Congress.

    That way he can avoid unproductive entanglements with Democrat sabotage.

    I see the smart of Trump’s approach. Give the man a chance, he’s earned it.

    ropelight (5d3e0e)

  19. Congress wants to save the insurance companies to save healthcare the same way they wanted to save the big banks to save the economy. Look how well that’s worked out. The demand for other peoples money always exceeds the supply.

    crazy (d3b449)

  20. The food plan provided that you could go in the store and get whatever you wanted. Pretty soon you’d have shortages of everything, as people ran in to stock up on stuff.

    Nort unless it was coming to an end, and people also go and stock up on food before a snowstorm or other adverse weather event.

    What happenes with medicine is not taht people try to get more and more, but doctors do. They actually encounter resistance – not price resistance, except for the minor cost of travel – but resistance cause dby inconvenience.

    There’s a whole lot wrong (and wasteful) with medical practice in the United states and maybe at the same time certain things should happen don’t happen.

    One of the things wrong is that there are too many visits to the doctor by too many people. A lot of doctors’ visits are simply to refill prescriptions, and they seem to have settled on a standard one visit at least every three months.

    Medical tests could be done by visiting nurses. They would report any anomalies to the doctor. Medical consultations could be done by telephone. At the same time, if there was a new problem or acomplication, someone should be able to see a doctor almost immediately (depending on what the problem was) When it was necessary, or optimal, for a doctor to physically see someone, the length of time of the consultation should not be the same for each patient. Which is surely bad practice.

    This is all occasioned by the way doctors are paid, and it can’t change as long as third party payments are involved. The third party could change it, but that’s hard.

    Sammy Finkelman (6f9f42)

  21. with food plan you can just run into the store then go home and make Totino’s Zesty Pizza Rolls Casserole

    a lot of people forget how it was before food plan

    plus you can freeze the leftovers

    happyfeet (a037ad)

  22. crazy (d3b449) — 3/21/2017 @ 11:38 am

    Look how well that’s worked out. The demand for other peoples money always exceeds the supply.

    taht applies to education also, another thing not paid out of cureent income.

    Financial aid, though is different. When it comes to Medicaid everyone involved wants people to qualify, either out of a general feeling of trying to help people, or in order to get paid, so it si very sloppy

    Not so with education. Education is free and mostly compulsory K-12, although not necessarily very good, and not used by many people, but the financial aid process is extremely complicated for college, which is not compulsory and people drop out of the application process.

    I don’t think this person’s solutions are very good, but it shows you the problem:

    https://library-assets.cappex.com/fafsa-discrimination-new.pdf

    Financial aid applications appear to focus more on preventing middle‐ and high‐income students from
    looking poor than on enabling low‐income students to afford a college education. This increases the
    length of the form and the complexity of the financial aid process. Low‐income students are less likely to succeed when forced to jump through a series of hoops. Each additional hoop provides another opportunity for failure.

    Sammy Finkelman (6f9f42)

  23. I think there’s almost nobody in Congress who realizes that the key problem is too much third party payments. And yet you can’t go to a free for all. You can’t even even out the amount of money people have to spend because people have different needs.

    With food you’re at least approximately at the same order of magnitude for eople. The biggest difference in cost is whethwr people prepare their own food or not.

    Sammy Finkelman (6f9f42)

  24. Patterico,

    I gotta ask, since your dream of a free market in health care is effing impossible given the stranded interests that would result, is TrumpCare a bad plan given the rest of the system will not change?

    Analyzing a proposal on the basis of what might happen if Jesus came down and straightened us all out isn’t useful. It’s just a lonely rant.

    Is it a useful step forward? Does it remove significant government control? Does it allow more choice? Does it avoid collateral damage? Does it make the playing field more level?

    I think it does, and I think “Do no harm” should be a watchword in healthcare reform — something Obama noticeably ignored.

    I would like to see a transition to purely individual/family policies, with risk-rating locked in by continuous coverage with any vendor(s). Perhaps there is a (money, not risk) subsidy for the poor. Perhaps there is a tax credit or deduction. Employers could subsidize/match/pay for the plans with taxable funds. The pool and coverage would be national, although there might be an offset for location (quality health care is more available and probably cheaper in Los Angeles than in Pinpoint, GA).

    But this is not going to happen in one fell swoop. Stop assuming it can.

    Kevin M (25bbee)

  25. Why does everyone assume they will be the omelet and not the egg?

    Kevin M (25bbee)

  26. #4 see #24

    Kevin M (25bbee)

  27. Franken drops back to the frozen frozen truck driver play…

    Colonel Haiku (de797c)

  28. Teh frozen chosen…

    Colonel Haiku (de797c)

  29. He’s unfrozen caveman senator without the guile…

    Colonel Haiku (de797c)

  30. 26… thx. I know you and your wife have paid dearly for your coverage after ChaunceyGolfprocare kicked in.

    Colonel Haiku (de797c)

  31. We’re resorting to government healthcare only because the free market has not worked.

    That’s not a fair statement. The healthcare system in the US hasn’t been a free market for as long as I can remember.

    In a real free market, the consumer of a good is the person paying for it. But we’ve gotten so used to having things paid by health insurance the we don’t see what the real costs are.

    We treat health insurance unlike any other insurance in our lives. Normally, insurance is there to protect you from a financial loss that you cannot weather. Fire insurance on your house, for example. Or collision insurance on your new car; when you’ve driven your car for many years, and the cost of replacing it is much lower, then you tend to drop collision insurance. But we treat medical insurance as if it were pre-paid health care, using it to pay for ordinary physician visits and routine prescriptions.

    There are so many more problems with the way we do things, but saying “the free market has not worked” belies the fact that the market hasn’t been free.

    Chuck Bartowski (bc1c71)

  32. Haiku–

    I have a lowest premium (but not low premium) high deductible ACA plan. The deductible is a few dollars short of the Max-Out-of-Pocket, so it isn’t strictly “catastrophic” but it’s very close. I also have an HSA. Since both I am my wife are in our 60’s, this isn’t cheap. We had insurance before Obama, but it got canceled. Since the ACA started we have both developed conditions that would likely have disqualified us for coverage in the old system (had we not already been covered).

    What the Ryan plan does:

    1) It has a better way of doing subsidies that does not require a person to predict their income 14 months in advance; nor does the subsidy cut off abruptly, eliminating the ACA’s welfare trap. This is particularly important for older people, where the tax credit drops abruptly to zero from about $4K/person. In the House plan, it tails off gradually, preventing a cliff.

    This is a big deal.

    2) It removes a large number of required coverages that drive the price up.

    3) It eliminates the requirement that one get coverage from an Exchange provider to get the tax credit. This also eliminates some of the narrow network issues.

    4) It pretty much eliminates the need for Exchanges.

    Things I don’t like:

    1) The subsidies are not large enough for low-paid workers (who don’t qualify for Medicaid), and are too large for the middle-class. They should be phased out at a family income of about $100K, rather than $150K. A self-employed person making that much money can write off the premiums against income as a business expense.

    2) It doesn’t create a national pool.

    3) It doesn’t seem to have tort reform.

    What I don’t know is whether insurers will be allowed to offer plans that differ from each other. Right now, there are 4 fixed plans and at least 2 of them are nonsense if you are paying for them yourself.

    Kevin M (25bbee)

  33. @32- So your anxieties are due to the corporate complexities created by insurance.
    In Britain, Canada, France, Switzerland, Australia, Japan… etc., the focus is care– and you’re covered.

    DCSCA (797bc0)

  34. Patrick, none of this post will surprise any of your regular readers. These are points you’ve made, and others have made, for a long time. But I nevertheless want to compliment you for the concision and clarity of this post. Bravo.

    Beldar (fa637a)

  35. In Britain, Canada, France, Switzerland, Australia, Japan… etc., the focus is care– and you’re covered.

    Unless of course, you smoke, drink “too much”, are overweight, want something extra, or want it now. That’s why Canadians come to the US for treatment.

    Kevin M (25bbee)

  36. BTW, does Murphy’s analogy include the refutation in the next paragraph, or did you add it? Because, as you say, there has not been a free market in health care since at least 1966, and probably longer considering the distortions that union, government and other health plans put on the rest of the market even earlier.

    Kevin M (25bbee)

  37. Pretty soon you’d have shortages of everything, as people ran in to stock up on stuff.

    Except for prescription drugs (and there’s a limit there, too), I don’t see how one can run to the hospital and stock up on medical care. Most purely optional things are not covered (e.g. cosmetic surgery), and — outside of government employees — dental coverage is pretty limited on most plans.

    Kevin M (25bbee)

  38. 31. Chuck, health insurance was only put there to protect us from outrageous bills. Imagine having to pay for food insurance in case you ran up a $50,000 food bill all of a sudden (and you had to do it). Insurance companies help drive the costs down actually. If you pay a medical bill yourself, it will likely cost you twice as much as what an insurance company pays. Insurance is socialism anyway in that it spreads the costs to a group of people. It was an artificial apparatus put in place to protect us from medical costs, born in your precious free market.

    I will agree with one aspect of what you’re saying: consumers do need to have some “skin in the game” and have to pays some on their own so that they make smarter decisions. I’ll give you that.

    Tillman (a95660)

  39. I do have to say I think Trump’s GOP-bashing isn’t very helpful. Threatening Congress seems counterproductive, as in “that’s 5 more votes for impeachment.” Trump is in great danger of sounding like a guy screaming “I’m the LEADER, you have to follow me!”

    Then again, Trump might go for plan B, which is to propose something the Democrats would prefer.

    Kevin M (25bbee)

  40. Kevin M (25bbee) — 3/21/2017 @ 3:16 pm

    I don’t see how one can run to the hospital and stock up on medical care.

    You don’t. It’s the doctors and hospitals who multiply billable visits or manipulate things so as to get paid more.

    The simplest thing is to have people coming in for repeat visists or screen people for diseases.

    Sammy Finkelman (6f9f42)

  41. @35. OIC. America’s healthcare system is overextended and overpriced because chubby Canadians are elbowing Americans out of line to get care. And here we always thought it was the Mexicans.

    In the UK, etc., you get the care you need, when you need it. And who the hell wants something ‘extra’ in healthcare? My late grandfather worked on hospital boards in the Pgh area for years and nobody– and I mean nobody— ever asked for anything extra in a hospital bed– only how fast they could get home.

    DCSCA (797bc0)

  42. Food is pure free market? Silly rabbit.

    https://en.m.wikipedia.org/wiki/Wickard_v._Filburn

    And this: https://www.boundless.com/economics/textbooks/boundless-economics-textbook/agriculture-economics-37/introduction-to-the-agriculture-economics-137/price-supports-541-12638/

    The agriculture industry is a critical component of any national economy because it represents both a substantial portion of gross domestic product and it is a core necessity for citizens within the system. Due to the fact that these goods are necessities, it is also important to keep in mind the way in which supply and demand would operate if there was a limited supply (required for survival, and thus potential demand upsides could be boundless). Due to these factors, governments enact a variety of price controls on the agriculture business, both in the U.S. and abroad. […]

    The United States currently pays out around $20 billion annually to farmers and producers in agriculture in the form of subsidies via farm bills in order to artificially reduce prices and shift the supply curve outward to ensure the overall supply in the market is high enough to satisfy all prospective consumers […]

    The subsidies provide a price floor (or a minimum price in which farmers can be reimbursed for certain products). This is a significant economic policy of price control to ensure farmers have proper incentive and revenues to continue to produce at the level of goods desired by the U.S. government. Agricultural economics is a highly complicated market as a result of these price supports and controls, particularly from the perspective of subsidization and price control.

    Anyway, seems to me Trump is trying to fix the thing, as much is as possible for the time being and with more plans for the future, but as usual conservatives demand all or nothing, and will be happy with nothing as long as they can claim their pure principles are unsullied. That attitude is why we are constantly ratcheted left, and I for one am tired of noble defeat instead of incremental progress. YMMV

    Leon (168f33)

  43. If this passes the remaining bills will be heavy with swine pay-back.

    mg (31009b)

  44. Kevin M (25bbee) — 3/21/2017 @ 2:01 pm

    where the tax credit drops abruptly to zero from about $4K/person. In the House plan, it tails off gradually, preventing a cliff.

    There’s still a cliff where Medicaid cuts off (the subsidy at theh lowest income level is not enough to buy what Medicaid pays for as you point out) and Medicaid also requires that income be predicted or the benefits repaid (but nobody tells people that)

    One thing about Medicaid – you can get covered retroactively, and no other form of “insurance” does that! Hospitals will see to it that people get it. Obama got a lot of people to get Medicaid before encountering a bill. Going on Medicaid does not improve health statistics.

    Sammy Finkelman (6f9f42)

  45. @43. Again, it’s a fight over insurance, not cost-effective healthcare.

    DCSCA (797bc0)

  46. #38 Tillwoman,

    A $50K food bill all of a sudden?
    Wut?

    A family’s food bill is generally consistent from week to week.
    What are you suggesting — that a family all of a sudden decides to buy $20K in ice cream for their 4th of July party?

    You lefties are something else.

    Food bills are consistent, but medical bills are not, for obvious reasons.
    Seriously, dude.

    Cruz Supporter (102c9a)

  47. I doubt Trump knows that crimaleins will have an avenue to chamber of commerce care.
    I keep praying ryan gets tossed from his lame duck speakership.

    mg (31009b)

  48. Anyone see the report on the FBI tapping Trump Tower in 2013?

    http://nypost.com/2017/03/21/fbi-bugged-trump-tower-while-probing-russian-gambling-ring/

    NJRob (ce94ac)

  49. @46- If only. Food bills are rarely ‘consistent’ and costs can spike, with respect to a monthly budget, particularly for fixed income families. Sale on corn flakes and tomato soup in April? Stock up. Big storm coming? Stock up! Ever heard of ‘pantry loading?’ –it’s a sales gimmick used by package goods manufacturers in conjunction with retailers annually in the August/September time frame. Tillman may have exaggerated the cost in his example but generally speaking, the mark-up on food in America is low due to the volume of product moved- but not so with healthcare products and services. It’s a racket the pols want to preserve thanks to big pharma and the insurance industries, which finance their campaigns.

    DCSCA (797bc0)

  50. DCSCA!

    Of course food bills are consistent.
    You’re talking about the price difference of thirty or fifty cents on a can of soup or a gallon of milk.

    Our Alinskyite friend Tillwoman is talking about tens of thousands of dollars on a food bill. That’s not exaggerating — that’s propaganda.
    There isn’t a family in America who has a food bill of “TENS of thousands of dollars.”
    That’s silly nonsense by left wingers who want other people to pay their way for a 5 star existence.
    “Low income” people are already on food stamps.

    Cruz Supporter (102c9a)

  51. No, it’s more than a few pennies. Besides, the food analogy is a bogus comparison to healthcare costs. And no, not every ‘low income’ person is on food stamps. That’s genuine propaganda.

    DCSCA (797bc0)

  52. “Mr. Trump won the presidency in part because of some big promises, including a vow to break from conservative orthodoxy on entitlements. If Congress fails to deliver on that promise, Mr. Trump could correct it by going boldly in a direction anathema to many on the right but potentially acceptable to some Democrats: universal coverage for catastrophic care.

    Many Americans’ greatest fear is that their health care costs will bankrupt them. The quality of care we receive is high — I experienced this myself this month after a cardiac incident left me reading the Republican plan in an emergency room — but the expense is opaque, and Americans are not wrong to worry about these costs.

    By providing catastrophic care for all, President Trump could ensure that everyone has an ultimate backstop against medical bankruptcy, while freeing the states to experiment with options for reform. It would also enable the private sector to offer new insurance products to supplement the basic catastrophic care coverage.

    This idea has some support among conservatives. In 2012 Kip Hagopian and Dana Goldman estimated in National Affairs that to insure all 209 million Americans not already covered by public insurance programs would cost about $2,000 per person, or $7,200 per family per year — about half the projected $1.7 trillion cost of Obamacare over the coming decade. Individuals and families could then purchase additional coverage given their particular health needs, but would not be bankrupted by severe illness or accident.”

    https://www.nytimes.com/2017/03/21/opinion/how-trump-can-fix-health-care.html

    Colonel Haiku (de797c)

  53. Ben Domenech… otherwise, I would have puked linking NYT

    Colonel Haiku (de797c)

  54. What happened to moving the bill through regular order as Ryan promised on its introduction?

    crazy (d3b449)

  55. And no, not every ‘low income’ person is on food stamps. That’s genuine propaganda.

    That’s true, not every. But about 44 million are.

    Rev. Hoagie® (785e38)

  56. @50. Postscript. See #13. And #45.

    The ideological and pragmatic clowns in both these political parties want to preserve this absurdly expensive and purposely complicated system for the insurance and big pharma industries to keep their campaigns financed.

    It’s a racket. A scam– and more and more Americans are wising up to it.

    Back in ’87, my BC/BS quarterly payments in metro NY were $125– a quarter. Granted some costs and aging changes that rate but even adjused for inflation, today it’s no where near that affordable for someone the same age in 2017. This racket is going to be busted up eventually– be it via a single payer/two tiered system or a ‘public option’ a a competitor to force p/s costs down. Because the battle now is repeatedly over insurance premiums costs, not providing cost-effective healthcare. The system in America is not sustainable long term– and why no sane nation would try to adapt the ‘American healthcare system’ as a model.

    DCSCA (797bc0)

  57. @55. Reaganomics.

    Try the ketchup soup tonight.

    DCSCA (797bc0)

  58. @54. This isn’t about healthcare. Remember your Trump 101:

    It’s about ‘winning.’

    DCSCA (797bc0)

  59. No, that’s increased income disparity after 8 years of Obamanomics… the top got fatter.

    Colonel Haiku (2601c0)

  60. 57.@55. Reaganomics.

    Try the ketchup soup tonight.
    DCSCA (797bc0) — 3/21/2017 @ 5:13 pm

    Other than your burning need to have the last word I don’t know what that means. What does the leftist term Reaganomics have to do with ketchup soup from the depression era and how does it relate to your “not every ‘low income’ person is on food stamps” statement. I agree , not every one is but again 44 million are. And we pay for that.

    Oh, and they don’t buy 50k in corn flakes to “pantry load”. That’s ridiculous.

    Rev. Hoagie® (785e38)

  61. @59. Nah, not going to blame any one administration about this– it’s a racket that has been ballooning for decades and the Congressional critters avoid it as long as their wheels are greased.

    DCSCA (797bc0)

  62. But you did…

    Colonel Haiku (2601c0)

  63. Kind of interested in how the law suits are going to go. New York versus Price?

    Will the Democrats argue the new healthcare tax isn’t repressive enough?
    Will the free marketeers join for expediency in order to get the case in front of Justice Goresucks all the faster?

    papertiger (c8116c)

  64. DCSCA, you’re absolutely right that comparing a food bill to healthcare is bogus.
    Just remember that it was Alinskyite Tillwoman who made that comparison.

    There are a lot of ways for a low income family to reduce their food bill.
    Beginning with eliminating junk food.

    When you have difficulty paying the rent, you just have to say “no” to Cheetos and Cokes.

    Cruz Supporter (102c9a)

  65. I’m getting mixed signals. If you’re ” not going to blame any one administration about this” what does:

    58.@54. This isn’t about healthcare. Remember your Trump 101:

    It’s about ‘winning.’

    refer to?

    Rev. Hoagie® (785e38)

  66. @62– Not really. This is a failure of Congress and just a mask for a battle over ideologies except their failure for decades wrecks lives. Big pharma and the insurance racket just got too greedy.

    DCSCA (797bc0)

  67. When you have difficulty paying the rent, you just have to say “no” to Cheetos and Cokes.

    Racist! I condemn you!

    Rev. Hoagie® (785e38)

  68. @65- Haven’t you been listening to him over the months? Haven’t you understood him by now? New Yorkers know his schtick inside out. Look at his heroes- Patton; MacArthur… look at his deals… even a loss is painted as a win… look at his denials of reality around him… look at how he treats women [Merkel, not even a handshake]… He doesn’t give a damn about the SCOTUS or healthcare or much of anything beyond himself and what he sees in the mirror and the deals he ca claim a win at. He’s all about winning– be it the news cycle, the TV ratings or an argument.

    He’s a sick man, Rev.

    In business it’s chalked up to being eccentricity; but if he was your daughter’s gym teacher he’d be under arrest. But he’s great entertainment. And that’s the thing– Americans don’t want to be governed– they wish to be entertained. So far, it’s been a great show to watch but not very promising for the reputation of the country.

    DCSCA (797bc0)

  69. I’d really like to hear what people who are not covered by a public employee “Cadillac” plan or by their employer think of this and/or what’s needed. The folks who have skin in the game…

    I have Kaiser Permanente. I’ll leave it to you to determine whether this is a “Cadillac” plan, but the people I see at Kaiser don’t look like Cadillac drivers for the most part.

    But anyway, this is like saying you’d like to hear what people who are dependent on welfare to live think about whether to get rid of welfare. I’ll tell you: they’re against it. That doesn’t mean that welfare is best for society, though.

    Patterico (115b1f)

  70. DCSCA (797bc0) — 3/21/2017 @ 5:45 pm

    🌟🌟🌟🌟🌟

    nk (dbc370)

  71. It has been a little than 50 years sin e they began messing eithmmedicare from the original bill to the hmo, erisa (certain privisos) emtala (Pete Wilson took credit for breaking that tie) Kennedy kasebaum to this leviathans.What glide path really works to solving this problem.

    narciso (d1f714)

  72. I gotta ask, since your dream of a free market in health care is effing impossible given the stranded interests that would result, is TrumpCare a bad plan given the rest of the system will not change?

    Let’s go back to my food example. If a party campaigned on repealing the food plans, and got into office and decided instead to tinker with the details, I would pass on the chance to discuss whether the tinkering improved the food plan or not. The problem is the concept that one can provide for food through central planning.

    But this is not going to happen in one fell swoop. Stop assuming it can.

    I’ll decline the invitation. In any public policy debate, there are people who concentrate on convincing people that the right thing to do is the right thing to do, and there are people who stand around warning that such explanations are pointless because nothing can change and certainly not that much and certainly not very fast.

    Very often the latter group is right. But not always.

    I don’t know whether this is one of those times when we can actually change things for the better. I tend to guess it’s not. I think we lost that chance when we (I use the word “we” advisedly as it encompasses neither of us) voted in Donald Trump over Ted Cruz in the primaries. But I just do not choose to be in the group of naysayers. I choose to try to convince people to do the right thing. Even when it feels like banging my head against a wall.

    Why I make that choice, I can’t really justify. But it’s the choice I’ve made. I won’t try to make you part of my group. Please stop trying to make me part of yours.

    Patterico (115b1f)

  73. So you don’t have a Cadillac plan as a public employee… so I guess you weren’t a part of that group. Most are, even well into retirement and even after death, as benefits are sometimes passed along to their survivors

    Colonel Haiku (2601c0)

  74. Kevin provided the kind of feedback I was looking for. I have coverage provided by my employer and also go to KP, Mr. Smartass. That’s why I have an interest in the opinions of those who have been most affected, certainly more than I have.

    Colonel Haiku (2601c0)

  75. And it’s also nothing like you’ve contended it is.

    Colonel Haiku (2601c0)

  76. Food is pure free market? Silly rabbit.

    From the post: “we have experienced a (mostly) free market in food.”

    “Mostly” is not the same as “pure” unless you’re a dishonest Trumper. Like Leon.

    Patterico (115b1f)

  77. And it’s also nothing like you’ve contended it is.

    What did I contend?

    Kevin provided the kind of feedback I was looking for. I have coverage provided by my employer and also go to KP, Mr. Smartass. That’s why I have an interest in the opinions of those who have been most affected, certainly more than I have.

    I’m interested in ideas that will fix the problem.

    I also recognize that there’s no getting there overnight and that there has to be provision for those who have relied on the current crap system.

    I’m not more interested in the ideas of people who benefit from central planning than I am in the opinions of those who don’t. That’s where we differ.

    Patterico (115b1f)

  78. Colonel, if the patients at your KP look like Cadillac drivers then we’re going to different KP facilities.

    Patterico (115b1f)

  79. @64. CS, remember, you can grow your own corn or tomatoes but you can’t remove your own appendix or gall bladder.

    “Food! Glorious food; Hot sausage and mustard; while we’re in the mood; cold jelly and custard…” ‘Oliver!’ 1969

    DCSCA (797bc0)

  80. Kaiser Permanente might not be the model of free market virtue signaling you would like it to be.

    papertiger (c8116c)

  81. OTOH given Kaiser’s beginning to end surf on government contracts throughout a period of 100% income tax, it’s practically a miracle any vestigial business with the name exists at all.

    papertiger (c8116c)

  82. That doesn’t mean that welfare is best for society, though.

    So, after having a plan I was paying for cancelled, and replaced by a plan that is significantly more expensive and less useful, and which I only get a subsidy for in a really bad year, you’d say I was on welfare?

    Or that, if I got a tax credit for something that 80% of the population gets a TAX-FREE subsidy from an employer, I’m on welfare (and they aren’t)?

    Kevin M (25bbee)

  83. Some Republican senators are coming out against a resolution that would repeal an Interior Department regulation governing oil and natural gas drilling on federal land. The rule is designed to cut down on the release of methane, a potent greenhouse gas.

    ex-military jag-off princess lindsey

    lobsterpot bimbo susan collins

    the ever-useless twat from the ever-useless state of ohio rob portman

    and colorado tea party trash cory gardner

    happyfeet (28a91b)

  84. Its entirely vekakte, I think that’s the proper idiomatic expression, the good part of this bill is it doesn’t reconfigure all plans, then again it doesn’t fix those plans that were so altered. That’s the bad news.

    narciso (d1f714)

  85. I know people in at least three of those states, these consuls give them agita

    narciso (d1f714)

  86. And no, not every ‘low income’ person is on food stamps. That’s genuine propaganda.

    I used to be nearly impossible for a person, or even a couple without children to get food stamps. But Obama “waived” all those rules. I imagine if they tried to enforce them now, some federal judge would rule that Trump hates poor people.

    Kevin M (25bbee)

  87. ““Mostly” is not the same as “pure” unless you’re a dishonest Trumper. Like Leon”

    You can argue semantics if it makes you feel special, but fact is you know little about farming.

    Raisin growers are fighting back against the USDA. Struggling small farmers have banded together to tell the federal government they will no longer turn over 47 percent of their raisin crop to the USDA each year. A little known and antiquated Depression era law still on the books allows the United States Department of Agriculture to seize nearly half of raisin farmers’ crops each year to “hold in reserve,” thus manipulating the supply and market price.

    The 47 percent of raisin crops the growers are mandated to give up annually ultimately wind up being sold to foreign buyers at minimal costs or given to the public school system. The small amount of money raisin farmers were eventually given by the federal government for nearly half their yield has dwindled significantly in recent years.

    http://www.inquisitr.com/1105608/raisin-growers-file-lawsuit-against-usda/

    Food production is not even “mostly” free market. Here, try reading the last of the quote in the comment you criticized again:

    Agricultural economics is a highly complicated market as a result of these price supports and controls, particularly from the perspective of subsidization and price control.

    And as far as it goes, the first part of the quote does make a good comparison between food production and the health care debate. Just substitute “healthcare industry” for “agriculture industry” and “gross domestic product” with “the economy”.

    The agriculture industry is a critical component of any national economy because it represents both a substantial portion of gross domestic product and it is a core necessity for citizens within the system. Due to the fact that these goods are necessities, it is also important to keep in mind the way in which supply and demand would operate if there was a limited supply (required for survival, and thus potential demand upsides could be boundless).

    Call me dishonest if you like, but it your description of the food market that is dishonest, not mine.

    Leon (168f33)

  88. there has to be provision for those who have relied on the current crap system.

    As if anything about Obamacare involved being willing, a precursor for “reliance”.

    Kevin M (25bbee)

  89. I don’t know what goes on with county workers these days — pretty sure it isn’t 1997 any more. BUt google around for the federal health plan and you’ll see not a Cadillac but a Maybach.

    Kevin M (25bbee)

  90. This is part of the cloward and piven, like overloading the welfare rolls in NYC in the 70s.

    narciso (d1f714)

  91. our friends tillman and dcsca might be onto something

    we need federally-mandated insurance for food so that if a family’s weekly bill jumps up to $50K for some republican-conspired reason such as the dairy industry begins charging $10K a gallon of milk or Frito Lay begins charging $5K for a bag of chips, then the lower income citizens among us can still afford to pay for them so they won’t starve to death or whatever

    omg

    Cruz Supporter (102c9a)

  92. Does anyone realize that Congress writing a health insurance/health care bill is a form of central planning? So of course the bill isn’t too good, especially given the constraints they are operating under,* and the speed with which they are writing it.

    But it’s unavoidable. The thing is not to do it too much, or too often.

    —-
    * Like not trying to increase the deficit and getting votes only among Republicans, and needding to get aout 90% of them – not that it would be easy to crack the Democratic monolith. Maybe crack it first with something else.

    The thing is to create a plan that allows for input by people following their own judgement, and for the plan itself to have flexibility, and to specify as little as possible, and to change it if it’s not working right, and a big thing to have people in plcace who will do that.

    It’s like writing a piece of software.

    You’ve got bear in mind that the United States constitution is a form of central planning. It may be more or less the right kind of central planning, but it central planning, and of course you can do things wrong. Government is central planning. Even more so a banking system, and that’s not so bad.

    It’s difficult to do halfway right but not impossible if people are careful and limit what they do. Now a lot of that what they did in 1787 was based on experience, and reading of history, and 25 years worth of discussion since 1763.

    Sammy Finkelman (3ea6b3)

  93. My entertaining Trump moment of the day:

    So ‘Mr. Tee the CIC’ is in the Oval signing the NASA authorization bill today w/some Congressional critters and some space folk. Cameras roll and Donny The Tee cracks wise about how hard it looks like it is to be an astronaut and he wouldn’t do it– then asks attending weasels Cruz and Rubio if they would. Banal banter came thudding back to earth with TedToo’s lame line, ‘We could send Congress into space.’

    So the ever earnest Vice President Pence pipes up– ‘What about Senator Nelson– anything to say?’ Trump instantly bigfoots a him, “I wasn’t going to ask him– he’s a Democrat.”

    ‘Course not. Because Senator Bill Nelson of Florida is also the only sitting member of Congress who has actually flown into space as a payload specialist aboard STS-24 in January, 1986.

    Why ask someone who knows better than you when you can better them with bullsh*t.

    Such a showman. That’s our Donald.

    No bucks, no Buck Rogers.” ‘The Right Stuff’ 1983

    DCSCA (797bc0)

  94. @91. Food, hell. Was thinking more along the lines of air. But could a GOP plan charge users per inhalation or exhalation after use then tax the added CO2 as a single breather per nostril or through both as a pay per breath. Maybe bulk breathing by open mouth could be in Bucket B before you kick the Bucket C.

    “Who knew healthcare was so complicated?: – President Donald J. Trump

    DCSCA (797bc0)

  95. Paul, Collins, Lee and Cotton are rather firm “nays” on the proposed Trumpcare bill today. None of them give a tinker’s damn about the terrible Wrath of Trump and I doubt McConnell will exert any real pressure on an issue which he would prefer to visit next year rather than this year.

    I’m very glad the Speaker gave the President the opportunity to shape aspects of the current bill to the point where the President could publicly add the tremendous value of his very vocal support to the legislation. I certainly hope the Speaker takes full advantage of each teachable moment which arises in order for the President to reach a more complete understanding of the true value and power of his position wrt proposed legislation.

    Rick Ballard (875edc)

  96. Stay off the brown acid, man of mystery:

    http://miamiherald.typepad.com/nakedpolitics/2017/03/trump-signs-nasa-bill-in-oval-office-with-nelson-at-his-side.html

    Yes they chopped up this dog food, now they have to sell it to the pouches.

    narciso (d1f714)

  97. 78… no, KP isn’t Cadillac by any stretch, but it’s decent and although my monthly co-pay has gone up a 100% over the last 2 years, it wasn’t high to begin with. I have few complaints, but then I haven’t been seriously ill and neither has my wife… yet, knock on wood. I have friends and some extended family members who are well covered as teachers, administrators, dept. heads in the public sector and they definitely have excellent plans. My sympathies are with the folks who have been subjected to what ACA has wrought.

    Colonel Haiku (2601c0)

  98. If you want to know how screwed we are, really get some perspective of how far we have strayed from constitutional governance, read this story about the redemption of Davy Crockett.

    And weep.

    http://personalliberty.com/sockdolager-a-tale-of-davy-crockett-charity-and-congress/

    Leon (168f33)

  99. 31. Chuck, health insurance was only put there to protect us from outrageous bills.

    Health insurance was available in the 1960s, and health care was a LOT cheaper then (as measured by percentage of GDP). But back then, health insurance was a plan of indemnity with a deductible. You paid for health care, submitted the bill to the insurance company, and got partially reimbursed. You had an incentive to shop around for a lower payment, and you knew what health care was costing. You also had an incentive to avoid unnecessary tests and doctor/ER visits.

    Somewhere along the line, the medical care givers started billing insurance directly. Convenient for the patient, to be sure, but then the patient was completely removed from the cost of the services he sought. Thus, the patient had no incentive to shop around or avoid unnecessary expense.

    Let’s not forget that government payment of health care costs in the form of Medicare and Medicaid started in the late 1960s, and it’s not at all coincidental that costs to the consumers started rising then.

    Again, the health care system in this country has definitely not been a free market, so it’s not fair to call it a failure of the market.

    Chuck Bartowski (211c17)

  100. As a payload specialist, Nelson’s role on the mission was as a congressional observer[8] and as a subject for medical experiments on space motion sickness.
    The space sickness he experienced during the journey was so severe that a scale for space sickness was jokingly based on him, where “one Nelson” is the highest possible level.

    papertiger (c8116c)

  101. DCSCA,

    Like most well-to-do liberals in retirement, your empathy is with the lower classes who make impulsive choices on a daily basis rather than with the working/educated classes who tighten their belts and try to save for a rainy day.

    Cruz Supporter (102c9a)

  102. Global warming potential is an undefined bit of propagandistic wordsmithery.
    The equivalent of buzz words like sustainablity or clean energy.

    Beside the point, methane is a lighter than air unstable molecule that breaks down naturally in the presence of halogens.

    papertiger (c8116c)

  103. Someone bring Congressman Nelson his bucket so he can regale us with a recreation of his adventures in space flight.

    papertiger (c8116c)

  104. Do squirrels fart methane?

    nk (dbc370)

  105. Who you asking, nk?

    I know that turkeys don’t fart. It’s because of their rudimentary GI tract.

    That’s where my special insight on the subject ends.

    papertiger (c8116c)

  106. Secretary of State Rex Tillerson: ‘I didn’t want this job. I didn’t seek this job… I took it because my wife told me God wasn’t through with me and it was the thing to do. She was right.’

    Sleep well, America.

    “Wellll….. isn’t that special.” – ‘The Church Lady’ [Dana Carvey] SNL

    DCSCA (797bc0)

  107. Paper-103, just invite Happyfeet to Salt Lake City, works just as well.

    urbanleftbehind (847a06)

  108. @100/103. Which puts Nelson in a class w/about half the astronaut corps– and the great Frank Borman, who threw up for a day on the way to the moon aboard Apollo 8 back in ’68, and kept it secret by putting word of it into a routine tape dump to be played back many hours after.

    _______

    @101. No actually, it’s w/my mother, who turns 86 tomorrow, and is a living example of how our elderly survive on a fixed SS income– in her case about $14,000/yr.

    DCSCA (797bc0)

  109. You can’t put nelson on the same plane (geometric) as borman,

    narciso (d1f714)

  110. Happy birthday for her then.

    narciso (d1f714)

  111. @109. The inclination is to do so. 😉

    DCSCA (797bc0)

  112. @110. Dementia makes it a birthday but not happy but I’ll pass the word along.

    She has to ask how old she is. But remembers December 7, 1941 like it was yesterday. Peculiar and horrible disease.

    DCSCA (797bc0)

  113. DCSCA, that’s right old timer, keep quoting tv shows and old movies when you can’t make an argument.
    You have a pension, but you don’t even have real money.
    That’s what you resent people who actually have real money.

    Cruz Supporter (102c9a)

  114. Half Nelson is a movie about an idealistic inner-city junior high school teacher who spends most of his non working hours drunk.

    Works for me.

    papertiger (c8116c)

  115. @113. Huh? There is no argument- it’s a matter of fact: the primary objective of the healthcare system in the United States is to make money, not deliver cost effective healthcare to the citizenry. Once this mind set shifts, the U.S. will adopt a single payer/two-tiered system and join the 21st century.

    And CS, don’t belittle yourself. I know it’s hard for conservatives at heart, but respect the elders. It speaks better of the society you live in and produced them– and you. They’ve earned it.

    DCSCA (797bc0)

  116. Hopefully enough republicans will man up and shoot this ryancare and ryan down. Ryan has got to go.

    mg (31009b)

  117. @113. Postscript. Golly-gee, CS, guess the newer comic books flicks appeal more to your Comicon tastes of late.

    Accordingly…

    “I’m done trying to convince you.” – Peter Parker [Toby Maguire] ‘Spiderman 3’ 2007

    DCSCA (797bc0)

  118. That’s like Galactica 1980, with Barry van dyke, lets nit speak of it, Garfield was too morose, perhaps Holland can resurrect the granchise

    narciso (d1f714)

  119. @116. Regardless of whether you like it or not, it’s probably politically prudent for Ryan to press the two-year termed GOP House members to passed it, go home and crow about it, and toss the turd into the Senate and let the six-year termers flush it away. That way, no sh-t on him.

    “Sh*tttttttt!” – ‘Butch Cassidy & The Sundance Kid’ [Paul Newman & Robert Redford] 1969

    DCSCA (797bc0)

  120. @79 DCSCA

    A Russian doctor removed his own appendix, in Antarctica. Leonid Rogozov.

    Pinandpuller (3651db)

  121. And Kent mccord, from Adam 12

    narciso (d1f714)

  122. @120. There’s always a show off. Howzabout that gall bladder? Still, another triumph for Vladimir Putin to trumpet about: Russian healthcare!

    Where do we sign up, comrade?!

    DCSCA (797bc0)

  123. @121. Those showbiz folk– always seeking attention. The gall bladder of him.

    DCSCA (797bc0)

  124. papertiger

    Too bad Ted Nugent didn’t do any marketing for Tang. Like the anti-Anita Bryant.

    Pinandpuller (3651db)

  125. Kent McCord removed his own appendix? Did he at least get started on a bag of D5W?

    Pinandpuller (3651db)

  126. @96. Throttle down, narciso. ‘Fake news.’ Catch the video if it’s aired. Mister Tee, the CIC, ignores Nelson then bigfoots him when Pence tries to bring him into the chatter. It’s actually pretty funny, if not pathetic.

    DCSCA (797bc0)

  127. The thing that is impressive about Sen. Nelson, (true of all of the astronauts{from Howard Wolowitz on down}) his flight was just prior to the Challenger explosion. Payload Specialist Christa McAuliffe was his “classmate” if you will.

    I just included the vomit story because it was fun.

    papertiger (c8116c)

  128. DCSCA

    I had gall bladder rejuvenation. It’s totally tight now.

    A couple of sheep men were talking. “Say, Joe, didn’t your wife just have a baby?” “She sure did, Con. It was pretty rough on her. She ended up with a hundred stitches.”

    “Hell, Joe, it only takes six stitches to sew up a wool sack!”

    A rancher’s prize stud got cut on a barbed wire fence and the vet came out to stitch up the wound.
    “You may not believe this,” he told the rancher, “but the best thing you can do is go to the store and buy some maxi pads to put over this.”

    Cut to the rancher awkwardly looking around the ladies aisle. “Can I help you?” a clerk asked. “Yes, I’m looking for some maxi pads,” he replied. “Do you know what kind you need?” the clerk asked.

    “No, all I know is,” the man began holding his hands six inches apart,” the gash is this big.”

    Pinandpuller (3651db)

  129. @127. Well, at the time Nelson and Jake Garn were accused of taking a spot from legitimate astronauts flying as a ‘junket’– if memory serves Nelson was on the appropriations committee so he wangled the ride… and STS-24 had several delays– one when fuel [liquid oxygen of memory serves] was inadvertently drained from a tank and had they launched it would have aborted and had to return to KSC. The problems were beginning to surface. He was lucky– 51L (STS-25) was just two weeks later and he could have been put into Jarvis’ slot.

    DCSCA (797bc0)

  130. I agree with Patterico’s analogy with food, but I have a question.

    In the event that everyone grew up with food plans for decades and that the free market would be the answer…what would be the best way to transition to a free market from that system? Food producers would be aligned to serve the food plan system and an abrupt change in system could indeed cause disruption and problems of it’s own. Would the solution be a new 5 year plan to transition out of the old system into the a free market system?

    Dejectedhead (6f26f8)

  131. @130. It’s a bogus analogy. A veiled feign to Soviet-styled 5 year plans by ideologues.

    You can grow your own beans.

    DCSCA (797bc0)

  132. Here’s where the Trump supporters need to realize their hero is no hero. He ran as an outsider and is being trucked by the usual denizens of the Swamp. DJT swore the holiest of holies that Obamacare was to be uprooted – not simply replaced. The feds were to get out of the whole healthcare industry to the extent possible.

    Now? He threatens Senators and Reps who are insisting he live up to those promises.

    The first immigration EO? He punted when confronted. Where’s the urgency in responding to the latest judicial tyranny which blocked the current EO? How about the complete refusal to back up his order on flight electronics for passengers on identified routes?

    DJT makes it up as he goes along and had made a nice living with bluster, backed with legal machinations of process which proved ruinous to many enemies. Now, he is up against real power who practically invented that game and who have everything to lose, should he prevail.

    You think he will withstand? Riiiiight.

    Ed from SFV (3400a5)

  133. Would the solution be a new 5 year plan to transition out of the old system into the a free market system?

    Maybe, but a lot of people (who are insulated from any of the transitional hardships) would stand on principle and call it FoodCare Lite. While they got FoodCare premium. And unless someone on Kaiser is paying $1500 a month for it, it’s a premium plan compared to the Obamacare crap.

    GO EFFING LOOK AT THE PLANS AVAILABLE, then compare them to yours.

    https://apply.coveredca.com/apspahbx/ahbxanonym.portal?_nfpb=true&_st=&_nfls=false&_pageLabel=previewPlanPage#

    Use 90034 as the zip code. That’s a nice middle-class zip in west LA.

    Kevin M (25bbee)

  134. R.I.P. Chuck Barris, 87.. famed creator of….’ The Gong Show’

    Gene, Gene the Dancin’ Machine and Chuckie, Chuckie, Chuckie… fade to black!

    DCSCA (797bc0)

  135. The” Gong” was the star of the show.

    mg (31009b)

  136. The Gong Show was great, lowbrow, silly fun. A guy wearing a brown paper bag over his head had an entire career as a result of appearing on that show.

    Icy (a1e560)

  137. #131 You can also put on your own band-aid.

    Dejectedhead (6f26f8)

  138. i wish it were thursday so the house could reject this ridiculous ryancare bill what was ineptly crafted by pervy Mitt Romney’s sex poodle Paul Ryan

    but it’s wednesday all the same

    happyfeet (a037ad)

  139. No that was just in shark jumping period, comparison as with the homage to chips.

    narciso (47c179)

  140. This is CNN… https://pjmedia.com/instapundit/260503/

    Colonel Haiku (166a1b)

  141. I see dcsca has contributed 43 of the 140 posts so far. Gresham’s Law prevails.

    BobStewartatHome (448c1e)

  142. Minnesotans must be so proud of Franken and Klobuchar!

    Colonel Haiku (166a1b)

  143. My economics teacher would be so happy with your “utility” of Gresham’s Law, BobStewartatHome. And of course you are correct with even a cursory observation.

    Rev. Hoagie® (785e38)

  144. In reality, Colonel, Minnesota thinks it’s part of Canada. Perhaps it should be.

    Rev. Hoagie® (785e38)

  145. DCSCA

    If I were Chuck D I’d be looking both ways before I cross the street.

    Pinandpuller (16b0b5)

  146. I don’t get it.

    The House and Senate should pass a repeal bill and if Trump doesn’t sign it that’s on him. Why is this so difficult? Just do it already. This was the whole point of the past several elections so just do it.

    Dustin (ba94b2)

  147. I just got an email from National Restaurant Review of which I’m a subscriber and they had a big article about “chefs” joining together to make a benefit dinner for “the immigrants from the countries Trump banned”. Shows you how well informed these a$sho;es are. They even had one chef at a table collecting money for the ACLU. You know, to help defer the legal costs of brining in illegals and exploiting them as kitchen help. They had all the virtue signaling of die hard leftists and they seemed to have no problem tying their businesses to their politics. Apparently nowadays offending your guests is all the rage.

    I responded to their online article with a scathing comment which was published but I’m sure will disappear by the time I return.

    Rev. Hoagie® (785e38)

  148. DCSCA

    I forgot about Chuck Colson. He may be working backwards.

    Pinandpuller (16b0b5)

  149. A question for the anti MACAGA folks

    Is it your contention that Mr President Donald Trump is adding more stops on the train to Single Payer?

    Asking for a friend.

    Pinandpuller (16b0b5)

  150. @146 Dustin

    Pass the dang bill!

    Pinandpuller (16b0b5)

  151. @135. Created the ‘Dating Game’ and ‘Newlywed Game’ as well but ‘Gong’ was just a masterpiece of fun.

    _______

    @141. 44. So you do know how to get to Sesame Street. Another success story and rationale to keep funding PBS/CPB.

    DCSCA (797bc0)

  152. Is there a fear that repealing the ACA will result in problems like the immigration EO ie people stuck in ER’s? Is that fear realistic?

    Pinandpuller (16b0b5)

  153. Single Player is salable if not necessarily fiscally plausible years after a hard immigration stop. You could say he’s adding a stop or idling along at a slow speed along side a meatpacking plant, trying to sell a ________ dividend, reminiscent of the material benefit provision of the post-Cold War peace dividend which Bush I all too easily provided and led to his downfall.

    And at worst a repeal of ACA would be on a date either 12-31-## or 9-30-##, so the key is defining what date and what prepapatory procedures done before that date entitle the patient to have the subsequent procedure “covered” by ACA (test, diagnosis, then actual surgery). If you are looking at a calendar or scheduling software deciding when to visit the ER, you dont need the ER.

    urbanleftbehind (5eecdb)

  154. yeah if Trump don’t wanna sign it’s on him

    happyfeet (a037ad)

  155. @146- Dustin, it’s all about lobbyists and the free market.

    The heathcare industry bought those congressmen fair and square. Don’t like it, blame free market capitalism. It’s all about supply and demand. The limited supply of congress critters makes them kinda pricy, but if you can afford it, you can buy the bill YOU want.

    And remember, the free market way is always the best way.

    Leon (168f33)

  156. Leon,

    LOL.

    Dustin (ba94b2)

  157. Mr Puller asked:

    A question for the anti MACAGA folks

    Is it your contention that Mr President Donald Trump is adding more stops on the train to Single Payer?

    However many stops that train makes, eventually we will arrive at single-payer.

    The laughably-named Affordable Care Act was a sop to Republicans, a hoped-for method to get conservatives on board due to its reliance on the private insurance system. If the GOP hadn’t hung the name Obamacare on it, they could actually live with it, but they’ll never agree to support anything that gives credit to Barack Hussein Obama.

    So, now they’ve come up with Obamacare Lite, hoping to put enough changes into the ACA so that the previous President won’t get credit for it, but all that they’ve done is to take a pile of stinking [insert slang tern for feces here] and make it even worse. If the ACA was a lousy attempt at a universal health care coverage system using the private insurance system, the AHCA — are those the right initials? — will turn out to be an even worse attempt at doing so. If there was ever any hope of achieving universal coverage through the private insurance system, the Democrats and the Republicans have unwittingly colluded in eliminating that possibility.

    The coldly realistic Dana (1b79fa)

  158. Our esteemed host concluded:

    Freedom. The market. These are the mechanisms that will drive down the cost of health care and make it affordable.

    The obvious point is that while such might, might! make health care more affordable — as long as there are malpractice lawyers out there screaming “Cash, cash, cash!” I have my doubts — even much less expensive health care will be unaffordable for those at the low end of the income scale.

    Nobody else out there is willing to say what I’ll say, what I have said, that if you cannot or will not pay for your health insurance or health care, you shouldn’t get it. But if you are unwilling to say that, at least to yourself, then you can have no real objection to the government providing some form of health care coverage; the most you can do is quibble about how best to provide it.

    The very realistic Dana (1b79fa)

  159. 156.@146- Dustin, it’s all about lobbyists and the free market.

    Lobbyists are not the free market, Dustin. Lobbyists are crony capitalists and the result of a socialist government making rules in the market and “fixing” the outcome for it’s friends. Perhaps fascism? The free market has no one to lobby except the customers.

    Rev. Hoagie® (785e38)

  160. A couple things I don’t hear being mentioned that really do need to be pushed HARD:
    1. No, zero, nada, exemptions for anyone. Not Congress, not unions, not public employees, not churches and charities and non profits, not the President himself. We are ALL covered under the same plan.
    2. Limits must be set on malpractice awards. Even the best doctors make mistakes and the resultant harm needs to be addressed but there needs to be limits on the awards and limits on the lawyers cut.
    3. No elective procedures are covered. Not abortion, not sex change, not boob jobs, not nose jobs.

    Rev. Hoagie® (785e38)

  161. Our retired raconteur restaurateur wrote (and I worked hard on that alliteration!):

    No, zero, nada, exemptions for anyone. Not Congress, not unions, not public employees, not churches and charities and non profits, not the President himself. We are ALL covered under the same plan.

    What is the difference between that and single-payer? If the policy is the same, for everybody, and everybody is covered, that’s nothing for which private companies could compete, and nothing which would bring down costs.

    The Dana who spotted the problem (1b79fa)

  162. 106 re: 105 in the WSJ editorial thread:

    Blah Blah (44eaa0) — 3/23/2017 @ 8:42 am

    if the Freedom Caucus likes the bill you still want it to fail because Trump supports it?

    I don’t think that’s what Patterico means. He says the bill is a disaster. Trump is actually buying into legislative strategy but it looks like it’s notgoing to work. Theer are about 32 House Republicans who do not support the bill and they need to get 9 of them. And it looks they won’t and they will cancel the vote.

    The House bill, even if it passes cannot possibly become law. It contains a payoff for 5 or 6 New York AState repyblicans. It exempts all counties or jurisdictions with a population of less tahn 5 million from sharing Medicaid costs (after 2020) In other words, New York City would still have to pay its 13% or so. Congressman Collins claims New York State has a surplus.

    Mark Steyn sitting in for Rush Limbaugh, says that Ryan Care or Trump Care or whatever you call it doesn’t fix the problem and would continue to give us the worst of both worlds. He also ssys, of those involved, Donald Trump is the most likely to think outside the box. So there’s that.

    Sammy Finkelman (3ea6b3)

  163. Sean Hannity: We are now about 3 hours and 50 minutes away from a scheduled vote on the bill = the vote is scheduled for 7 p.m. EDT] and as of right now it doesn’t have the votes to pass.

    Sammy Finkelman (3ea6b3)

  164. One thing Sean Hannity notes is that this bill does not tell you what things are going to look like after Obamacare.

    As Mark Steyn noted, this is a more sophisicated version of Nancy oelosi’s “you have to pass the bill to know what is in it>” You have to see what the secodnd bill is like before you know what it does.

    It’s being done this way because of legislative strategy. (this does not come from Sean hannity or anyone on the radio today) Paul Ryan also wants to pass tax reform. Now if they pass this bill, the Congressional Budget Office will score it aas saving money (mostly because of cuts to Medicaid after the year 2020) That will enable taxes to be cut more without havinbg to raise other otehr taxes. They are like slaves to the CBO, which is wrong anyway.

    Sammy Finkelman (3ea6b3)

  165. urbanleftbehind (5eecdb) — 3/22/2017 @ 10:17 am

    the key is defining what date and what prepapatory procedures done before that date entitle the patient to have the subsequent procedure “covered” by ACA (test, diagnosis, then actual surgery).

    Standard insurance policies cover anything done during a certain time period, regardless of whether or not it could have been time shifted. Why should this be any different?

    Anything done before the policy expiration date is covered; anything done while the policy is not in force is not, and one species of fraud is for the doctor to lie about the date. And if subsequent necessary care won’t be paid for, well the doctor or hospital can decline to perform it.

    Sammy Finkelman (3ea6b3)

  166. I mean they can decline to do a transplant. They can’t stop in the middle because of medical ethics.

    Sammy Finkelman (3ea6b3)

  167. Nobody else out there is willing to say what I’ll say, what I have said, that if you cannot or will not pay for your health insurance or health care, you shouldn’t get it. But if you are unwilling to say that, at least to yourself, then you can have no real objection to the government providing some form of health care coverage; the most you can do is quibble about how best to provide it.

    As has been quipped about the oldest profession, we’ve already decided and are merely quibbling over price.

    “Bring out your dead! Bring out your dead!” – ‘Monty Python and the Holy Grail,’ 1975

    DCSCA (797bc0)

  168. But if you are unwilling to say that, at least to yourself, then you can have no real objection to the government providing some form of health care coverage

    That’s correct, and very few people hold to the idea that if you cannot or will not pay for your health insurance or health care, you shouldn’t get it. But what’s left is a big argument

    Some people who hold to the idea that government does not beed to be involved still hold to the idea that doctors, or people in general, have a moral obligation to see to it that medical treatment gets done, particularly emergency care or the delivery of a baby.

    And beyond not interfering with that, they may like government requiring that or strongly facilitating the medical profession policing itself in that direction.

    Sammy Finkelman (3ea6b3)

  169. I think this is alot like TARP. If the vote fails, there will be another vote.

    The big problem is that, although they had seven years to think about it, nobody worked out, or at least nobody seriously put forward, a good bill. (maybe there’s an obscure one around somewhere, that adds up and doesn’t create some big losers.)

    A second problem is that, no matter how you slice it, you won’t be able to pass anything without any Democratic votes. And it probably will not be easier if they pass Phase I through reconcilation.

    Sammy Finkelman (3ea6b3)

  170. The Ryan plan was a stop on the way of portable health care. The House Freedom Caucus intransigence will prevent that and lead inexorably to Trump joining with the Dems.

    Kevin M (25bbee)

  171. The honorable Mr Finkelman wrote:

    The big problem is that, although they had seven years to think about it, nobody worked out, or at least nobody seriously put forward, a good bill. (maybe there’s an obscure one around somewhere, that adds up and doesn’t create some big losers.)

    Your statement assumes that a good bill is even possible. To me, no nationalization of health care is a good thing.

    The Dana who isn't a physician (1b79fa)

  172. How much of what previously constituted the “healthcare system” – providers in particular- is still viable? I get the sense that many if not most have gone under.

    Colonel Haiku (8d00c4)


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