Author Topic: Obamacare/Trumpcare  (Read 6645 times)

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Re: Obamacare/Trumpcare
« Reply #45 on: March 08, 2017, 08:33:53 PM »

Online slamtheking

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I'm not sure how this is relevant to the healthcare bill...

It is relevant because people lose their insurance or gain as a result of these bills.  Also, I think my comments were more relevant than the above.
The problem with your comment is you can't decide to interview every poor person who receives Medicaid and subjectively decide if they are just being to lazy to go out to work and get their own insurance. Hell, the process of even trying this would cost more than just paying for these people's Medicaid in the first place.

I also think youwill get blowback from this type of statement because its a common right wing talking point to create class warfare against the poor. Are their people who take advantage of Medicaid, food stamps and other benefits to the poor? Sure. But how does that number compare to give backs to corporations or fraud against the government by corpirations in various forms?

Me, Iwouldrather provide the entitlements to the poor and put up with those that take advantage of it( which I also think is much smaller than most think) and focus our attentions on stopping the government from handing out billions in corporate entitlements or closing loopholes in the tax code so that corporations and Trump pay their fair share of taxes.

I know this is off topic but I felt Celtics4ever's comment warranted a response
TP - spot on Nick (as usual)

by the way, I did think there was one correction needed ;)

Left off defense contractors that steal more money from the government than anyone!
I just lumped them in with the corporations but by all means lets give them their own special shout out since Trump plans to jack up defense spending

Re: Obamacare/Trumpcare
« Reply #46 on: March 08, 2017, 09:22:56 PM »

Online liam

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I'm not sure how this is relevant to the healthcare bill...

It is relevant because people lose their insurance or gain as a result of these bills.  Also, I think my comments were more relevant than the above.
The problem with your comment is you can't decide to interview every poor person who receives Medicaid and subjectively decide if they are just being to lazy to go out to work and get their own insurance. Hell, the process of even trying this would cost more than just paying for these people's Medicaid in the first place.

I also think youwill get blowback from this type of statement because its a common right wing talking point to create class warfare against the poor. Are their people who take advantage of Medicaid, food stamps and other benefits to the poor? Sure. But how does that number compare to give backs to corporations or fraud against the government by corpirations in various forms?

Me, Iwouldrather provide the entitlements to the poor and put up with those that take advantage of it( which I also think is much smaller than most think) and focus our attentions on stopping the government from handing out billions in corporate entitlements or closing loopholes in the tax code so that corporations and Trump pay their fair share of taxes.

I know this is off topic but I felt Celtics4ever's comment warranted a response
TP - spot on Nick (as usual)

by the way, I did think there was one correction needed ;)

Left off defense contractors that steal more money from the government than anyone!
I just lumped them in with the corporations but by all means lets give them their own special shout out since Trump plans to jack up defense spending

You are right they are corporations, my bad. They do have a special place in the enormous waste spending.

Re: Obamacare/Trumpcare
« Reply #47 on: March 09, 2017, 04:39:32 PM »

Offline SCeltic34

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Admittedly, I haven't read the entire AHCA bill, but reading the summary and others parts of it it's clear that it's a disaster.  I don't typically like to debate such complex topics on the internet, but I figured I'd share some thoughts.  Simply put, it's not going to work.

Winners appear to be insurance companies and big pharma.  Mostly everyone else loses, including low-income people (and especially low-income women and children of low-income families), the elderly, the mentally ill.  Standard Republican fare.  Hospitals lose too.

Perhaps the greatest irony of all is that, as constructed, this bill will seriously harm rural citizens - i.e Trump's voter base.  Over recent times it's been increasingly difficult for those who live in rural areas to access health care for numerous reasons, primarily because of (but not limited to) (1) disincentivization and destruction of private physician practices (2) dearth of care systems in rural areas.  This bill is only going to make this problem worse.  Rural hospitals(or all hospitals) will take an enormous funding hit and thus resources to care for rural patients will be diminished.  Most of these people can't make regular 50-100+ mile trips to an urban area for care.  It's not feasible.  Talk about voting against your best interests.

Heathcare Savings Accounts, promoted by Tom Price, sound great in theory but won't work for most people, especially the poor.  These people don't have money to put into an HSA in the first place.  Probably will be good for those who don't really need them though.  Same thing with block grants, which is really about rationing resources and decreasing funding to vulnerable populations. 

Millions of people are going to lose coverage and costs will continue to rise.  The tax credits won't be sufficient - many people will still be on the hook for an enormous deductible.  Young, healthy people aren't going to buy insurance.  And it's going to cause serious economic hardship on much of the aging population - the people who are going to need access to health care the most.  Not to mention problems with the (1) per capita cap model for Medicaid; (2) allowing states to self-define high-risk pools and the option to withhold funding if they want (3) the egregious penalty (or incentive, depending on how you want to look at it) for not buying insurance or letting your insurance coverage lapse - a fat 30% premium surcharge. 

The Repubs have symbolically voted to repeal Obamacare over 50 times since 2010, and have had all the time in the world to formulate an adequate replacement.  And now that they finally have their opportunity, this is what they come up with.  The major underlying causes of exploding health care costs aren't addressed, and externality costs are largely ignored.  By the way, I'm not going to call the AHCA "Trumpcare" (although I'd love to pin such terrible policymaking on Trump) because Trump doesn't clearly doesn't know anything about health care.

Obamacare was bad.  This is worse. 


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Re: Obamacare/Trumpcare
« Reply #48 on: March 09, 2017, 04:55:18 PM »

Offline SCeltic34

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I'm not familiar with the nuance of either plan, but I think we absolutely need to focus on preventative treatment/lifestyle/medicine etc.

Also, I think the demand for healthcare services is just way too high for a variety of reasons. Among them is a culture of healthcare use/overuse/unnecessary treatments, which is partly due to having such an insurance-reliant system in the first place.

Health care should be ensured, not insured. Insuring health care is necessarily a loss for consumers and prohibitive for those who can't afford it. It creates barriers to access and raises costs disproportionately. Ensuring health care is difficult to achieve, but if done correctly, achieves goals of both availability and affordability of the health care system.

It's a radical move and cannot be achieved in one simple step, but insuring health care should be illegal and an alternative which guarantees service in a sustainable, quality way should be put in place. Until we do this, we are all losing. The question is just by how much.


I strongly agree the emphasis on health care should be on prevention. We will not see a single legitimate point in any health care plan from either party that makes an honest effort to improve preventative health care though, because prevention is nowhere near as profitable as treatment. They would crush one of the most profitable industries in the country if they really focused on prevention.
As a dyed-in-the-wool Democrat, I readily admit that ACA does not sufficiently address prevention either.  Ironically, that is actually the best solution to rising health care costs and would lead to a healthier population, which is the goal.

We all agree that preventative care is the real key.  The cost-saving effects won't be apparent in the short term (which is all politicians care about), but's it's one of the only realistic ways we can suppress long-term costs.

The real problem is that no matter how awesome your medical care is, quality health prevention is practically impossible to achieve for many people.  You can get the best advice from your doctor, cost-effective medications that keep chronic conditions well controlled (such as blood pressure meds), etc.  But the American environment as a whole is not conducive to good health, and much of it stems from poor policymaking.

Walk down a main street in a city and count how many cheap, unhealthy places there are to eat.  Similarly, walk through an impoverished area and notice the lack of availability of healthful food that is available (food deserts).  How easy it is to get cigarettes, alcohol, or illicit drugs.  How some poor areas don't even have clean air to breathe.  How sedentary many of our jobs are.  How most cities aren't conducive to biking or walking.   So on and so forth, you get the picture.

It's an imperfect analogy, but I liken it to transplanting a healthy liver into an alcoholic with a cirrhotic liver who is still drinking.  The solution (a healthy liver) will eventually once again become cirrhotic because the environment (constant exposure to alcohol) hasn't changed.  So too will preventative care fail as long as our environment isn't conducive to preventative health.

The only way to fix this is economic incentives.  That's all anyone cares about, whether it's rural voters or multinational corporations.  Incentivize healthy habits.  Subsidize fruits and vegetables.  Invest in recreational areas, bike paths, walking paths, whatever.  Disincentivize bad ones - for example, taxing tobacco has cut down on smoking, and now soda taxes are driving down soda consumption.  It works, and it saves money in the long run. 


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Pierce: "I called game."

- Paul Pierce on his game-winning buzzer beater, game 3 EC Semi-finals against the Atlanta Hawks

Re: Obamacare/Trumpcare
« Reply #49 on: March 09, 2017, 06:16:14 PM »

Offline mmmmm

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But we have some people who could work and don't. I could care less if they lose their insurance because unlike the above groups they choose not to work.  This to me is different than the working poor or disabled or mentally ill whom I don't mind helping.     

Do you care less if their children and dependents lose their insurance?

Ignoring the question of how you determine just who out there that is eligible for work and living in a community that has available jobs that they can do is deliberately deciding to not work ... what is your thought on the minor children and others who may be dependent on those 'slackers'?

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Re: Obamacare/Trumpcare
« Reply #50 on: March 09, 2017, 07:16:54 PM »

Offline Neurotic Guy

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But we have some people who could work and don't. I could care less if they lose their insurance because unlike the above groups they choose not to work.  This to me is different than the working poor or disabled or mentally ill whom I don't mind helping.     

Do you care less if their children and dependents lose their insurance?

Ignoring the question of how you determine just who out there that is eligible for work and living in a community that has available jobs that they can do is deliberately deciding to not work ... what is your thought on the minor children and others who may be dependent on those 'slackers'?

I think you point out that it's complicated.  Unfortunately, we neglect this discussion because liberals jump quickly to "you can't let people go hungry and without shelter or healthcare -- especially the kids", while conservatives jump quickly to "oh well... it's their problem -- they'll never learn if we keep enabling them".   Thus, we never have the discussion about the complications that I think the vast majority of us probably agree on.  Most Americans don't want able-bodied and able-minded Americans to cheat the government and collect welfare/Medicaid if they can work.  In addition, most Americans are troubled by innocent children not getting adequate healthcare or nourishment when their parents are neglecting their responsibilities.  An honest approach that might bridge (or avoid) ideological barriers, might be to actually get more facts.  I don't know what the facts are, but I do have an idea of some of the questions (please add others):

How many able-bodied and able-minded Americans are receiving welfare/Medicaid when gainful employment is readily accessible?

How many of these people have dependent children who are relying upon them for healthcare, shelter, nourishment...?

How many of the people we presume to be able-bodied and able-minded are actually mentally ill (including substance-addicted or suffering from debilitating trauma past or present)? 

What is known currently about the culture of poverty and the links to generational repetition of drug/alcohol abuse, mental illness (not just the genetic passing on of illness, but the cultural/sociological impact of growing up in a household with mentally ill parents), abuse, neglect, unintended pregnancies, poor nutrition, underdeveloped brain, underdeveloped executive skills?   With what is known, how can government programs be more proactive in offering supports beyond money and healthcare to families with multiple generations stuck in poverty?

What options, in addition to providing food and healthcare, are there for supports that might empower rather than enable families -- perhaps lessening the level of dependence on government or shortening the length of time on government programs?

What role can schools play, as a primary community link for almost all children, for providing family support, family-centered futures planning, psychological and psychiatric care, and nourishment/healthcare for children/families in need?

No one who is both charitable and sensible wants to pay ad infinitum for the healthcare, shelter and food for generations of families, especially those with adults who appear able to work.  Likewise, no one who is charitable and sensible wants another generation of undernourished, under-cared for children to grow up and repeat the cycle.  I have to say that it is my guess that there aren't too many families who are cheating the government year after year who are not suffering, in one form or another, from vastly dysfunctional dynamics and/or serious mental health factors.  That is not to say that there aren't people who are purely and blatantly cheating the government and taxpayers.   Unfortunately, I think we spend too much time fearing the fraud when we should be more focused on the bigger problems and developing solutions.

Re: Obamacare/Trumpcare
« Reply #51 on: March 13, 2017, 05:07:48 PM »

Offline fairweatherfan

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CBO report is in: https://www.cbo.gov/publication/52486

The big takeaway - estimated # of total uninsured in 2026:

American Health Care Act enacted: 52 million

Current law maintained: 28 million

24 million fewer insured in a decade, that's even higher than the 10-15 million estimates I saw earlier. And this kicks in fairly quickly with 14 million fewer insured by next year. 

There's also deficit reduction of $334 billion over 10 years, mostly due to Medicaid cuts and loss of subsidies.  And while premiums are expected to increase by 15-20% more than the status quo between now and 2020, they're expected to be ~10% lower than the status quo after 2020.  Impact on premiums would be much more positive for younger individuals and much, much more negative for older and sicker individuals.
« Last Edit: March 13, 2017, 05:14:15 PM by foulweatherfan »

Re: Obamacare/Trumpcare
« Reply #52 on: March 13, 2017, 05:15:24 PM »

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it is a mystery to me why americans vote for these ass clowns.

of course, it is also a mystery to me why americans are so simple minded about health care. most industrialized countries provide it more plentifully, more fully, more cheaply than the US. yet, so many americans prefer to pay more and get less care.
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Re: Obamacare/Trumpcare
« Reply #53 on: March 13, 2017, 05:54:55 PM »

Offline chilidawg

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it is a mystery to me why americans vote for these ass clowns.

of course, it is also a mystery to me why americans are so simple minded about health care. most industrialized countries provide it more plentifully, more fully, more cheaply than the US. yet, so many americans prefer to pay more and get less care.

Because freedom.

Re: Obamacare/Trumpcare
« Reply #54 on: March 13, 2017, 10:05:46 PM »

Offline hwangjini_1

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My, my...how things and words do change. From a SoSH posting:


Donald Trump: "Were going to have insurance for everybody. There was a philosophy in some circles that if you cant pay for it, you dont get it. Thats not going to happen with us. 1/15/17

Donald Trump: "Obamacare has to go. We can't afford it. It's no good. You're going to end up with great healthcare for a fraction of the price. And that's going to take place immediately after we go in. Okay? Immediately. Fast Quick." (CSPAN, Timestamp 34:23) 2/19/16

Donald Trump: "Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, "No, no, the lower 25 percent that can't afford private. But-- ... I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now." - 60 Minutes, 9/27/15

Donald Trump: "We're gonna come up with a new plan that's going to be better health care for more people at a lesser cost." ABC News, 1/25/17

Donald Trump: "There are people who say everybody should have a great, wonderful, private plan, and if you can't afford that, and there is a percentage, a fairly large percentage that can't afford it, then those people don't get taken care of. That's wrong. We're going to take care of that through the Medicaid system. Were going to take care of those people. We have no choice." Dr. Oz, 9/15/16

Donald Trump: "The new plan is good. It's going to be inexpensive. It's going to be much better for the people at the bottom, people that don't have any money. We're going to take care of them through maybe concepts of Medicare. Now, some people would say, "that's not a very Republican thing to say." That's not single payer, by the way. That's called heart. We gotta take care of people that can't take care of themselves." CNN GOP Townhall, 2/17-18/16

Donald Trump: "Im not going to cut Medicare or Medicaid." 5/21/15. The Daily Signal.
I believe Gandhi is the only person who knew about real democracy not democracy as the right to go and buy what you want, but democracy as the responsibility to be accountable to everyone around you. Democracy begins with freedom from hunger, freedom from unemployment, freedom from fear, and freedom from hatred.
- Vandana Shiva

Re: Obamacare/Trumpcare
« Reply #55 on: March 13, 2017, 10:15:52 PM »

Offline hwangjini_1

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Cripes, and just when you thought the White House could not possibly be an even more bald faced liar. The White House called the CBO report inaccurate in saying 24 million would lose health care coverage under the GOP plan. Turns out, the White House's own estimate was 26 million.

http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-236019

Geez Louise guys and gals, can't the US just follow the lead of South Korea and impeach the president?  ;D
I believe Gandhi is the only person who knew about real democracy not democracy as the right to go and buy what you want, but democracy as the responsibility to be accountable to everyone around you. Democracy begins with freedom from hunger, freedom from unemployment, freedom from fear, and freedom from hatred.
- Vandana Shiva

Re: Obamacare/Trumpcare
« Reply #56 on: March 13, 2017, 10:21:47 PM »

Offline Roy H.

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Cripes, and just when you thought the White House could not possibly be an even more bald faced liar. The White House called the CBO report inaccurate in saying 24 million would lose health care coverage under the GOP plan. Turns out, the White House's own estimate was 26 million.

http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-236019

Geez Louise guys and gals, can't the US just follow the lead of South Korea and impeach the president?  ;D

24 vs 26 million? Seems inaccurate to me. ;)

I'm surprised that Trump is backing this. This doesn't help or fire up his base, and both the optics and the effect on premiums seem to be political self-harm.


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Re: Obamacare/Trumpcare
« Reply #57 on: March 13, 2017, 10:36:09 PM »

Offline nickagneta

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Cripes, and just when you thought the White House could not possibly be an even more bald faced liar. The White House called the CBO report inaccurate in saying 24 million would lose health care coverage under the GOP plan. Turns out, the White House's own estimate was 26 million.

http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-236019

Geez Louise guys and gals, can't the US just follow the lead of South Korea and impeach the president?  ;D

24 vs 26 million? Seems inaccurate to me. ;)

I'm surprised that Trump is backing this. This doesn't help or fire up his base, and both the optics and the effect on premiums seem to be political self-harm.
If the CBO is correct, if this goes through and Trump signs it, he is going to enrage those poor working people that normally voted Democrat and voted him into office. It could cost him the Senate at the midterms and his Presidency in 2020 if the harm to the lower 20% of wage earners and the elderly is ofing to be as bad as projections have them.

Unbelievably, it might be the far right of the Republican party that saves him by not voting for this plan because they want nothing more than a complete repeal of Obamacare and a return to the system that was in place previously. How ironic would that be?
« Last Edit: March 13, 2017, 11:59:50 PM by nickagneta »

Re: Obamacare/Trumpcare
« Reply #58 on: March 13, 2017, 10:57:38 PM »

Offline SCeltic34

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I'm not sure if this link will work if you're not a member of MedPage Today, but this is an excerpt of the story:

https://www.medpagetoday.com/Washington-Watch/repeal-and-replace/63773?xid=nl_mpt_DHE_2017-03-11&eun=g845009d0r&pos=1

Quote
As the White House, Congress, and the public examine the Republicans' plan for replacing the Affordable Care Act (ACA), one thing analysts are looking at is how much of the ACA isn't actually touched by the proposal.

The answer: A lot, according to Timothy Jost, JD, emeritus professor at the Washington and Lee University School of Law in Lexington, Va."I think probably 90%-95% of ACA remains in place," Jost said in a phone interview. "The ACA covered so much ground, and nobody who had ever actually looked at ACA could have seriously thought you could repeal it, but basically this is limited to three titles of the ACA."

Other than insurance and tax provisions, many of the ACA's titles remain untouched, including those that emphasize public health and preventive care -- for example, provisions increasing coordination between preventive care task forces, increased educational outreach about prevention, and research on optimizing delivery of public health services.

The ACA also established a national healthcare workforce commission and increased funding for the National Health Service Corps. Other parts of the law deal with improving access to innovative therapies, strengthening the Indian Health Service, improving transparency in government activities, and increasing healthcare services in the community. None of these were addressed in the House GOP bill, either.

The biggest changes in the replacement plan have to do with all the taxes being repealed in the Republican plan, including a medical device tax and a tax on tanning salons, as well as a tax on higher income earners, according to Jost.

"The best way to think about this bill is it's a massive tax cut, particularly for the wealthy, with $300 billion in tax cuts for people making more than $250,000 a year, and a bill to cut Medicaid spending," he said. "The private market reforms are pretty much incidental."


But hey, at least the CBO projects a $337 billion in savings over the next 10 years or so.  Probably because elderly and poor patients will lose access to care over time and die a lot sooner.  As cruel as that sounds, it saves money.  Brought to you by the GOP.


Broussard: "Did you call bank?"
Pierce: "I called game."

- Paul Pierce on his game-winning buzzer beater, game 3 EC Semi-finals against the Atlanta Hawks

Re: Obamacare/Trumpcare
« Reply #59 on: March 13, 2017, 11:01:32 PM »

Online slamtheking

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Cripes, and just when you thought the White House could not possibly be an even more bald faced liar. The White House called the CBO report inaccurate in saying 24 million would lose health care coverage under the GOP plan. Turns out, the White House's own estimate was 26 million.

http://www.politico.com/story/2017/03/obamacare-uninsured-white-house-236019

Geez Louise guys and gals, can't the US just follow the lead of South Korea and impeach the president?  ;D

24 vs 26 million? Seems inaccurate to me. ;)

I'm surprised that Trump is backing this. This doesn't help or fire up his base, and both the optics and the effect on premiums seem to be political self-harm.
If the CBO is correct, if this goes through and Trump signs it, he is going to enrage those poor working people that normally voted Demicrat and voted him into office. It could cost him the Senate at the midterms and his Presidency in 2020 if the harm to the lower 20% wage earners and the elderly is goung to be as bad as projections have them.

Unbelievably, it might be the far right of the Republican party that saves him by not voting for this plan because they want nothing more than a complete overturn of Obamacare and a return to the system that was in place previously. How ironic would that be.
I wish I could share your 'optimism' about enraging the people that voted for him.  They weren't smart enough (or cared enough) to see him for the snake-oil salesman that he is and I seriously doubt they'd be smart enough to see (or admit) that he played them for fools. 

The support Trump continues to receive from his base regardless of the lies he spews almost daily continues to astonish me.  At this point, not only do I think the Dems will fail to even make inroads to regaining Congressional seats at the midterm, I seriously doubt the Dems can make him a 1-term president.  I think his political machine played the people and electoral college brilliantly and will sadly do so again in 4 years.  I can only hope the damage this administration causes to this country and the world can be undone.