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Saturday, 25 March 2017

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David, all you need to know about Obamacare is that it was designed to become an entitlement and then designed to fail...leading to the Democrats holy grail of single payer health care. To them that means success in the ever growing welfare state. To right thinking Americans, Obamacare is a failure because it was a naked power grab of the health industry by central planners at the expense of an individual's freedom to choose. It was conceived in bad faith by people of bad faith, sold to a gullible public in bad faith and when caught red handed on their lies, it was forced on us in bad faith, mandated and enforced by people of bad faith. Democrats took many casualties in delivering something so repugnant and so wrong. They have had 6 years to wrap its tentacles around the entire industry. It will take time and effort to unwrap these tentacles from the throats of free people and the industry as a whole. Trump may understand that now. To bring America back and make us great again, it will pretty much take defeating Democrats all the way.

The "additional" is correct as well. The Republican side is ideologically split because we are allowed to be. The Freedom Caucus needs to expand and pick up what few "blue dog Dems" are left. For the rest, it's easy to promise ever more of someone elses money. But that always ends and ends badly.

Duffers, the biggest problem is as you stated; a service with limited resources and unlimited demand. This is a disaster waiting to happen as anything the government gets its hands on it screws up. The result will be another yuuuge burden on the taxpayers and disgruntled end users.

IMHO it would be far better to free the system up and apply strict oversight to insurance companies, hospitals and Big Farma.

Timbo, you're on the right track. The free market can work if allowed to. We know what happens when government runs things. But that is the ideological chasm. One side has an easy sell as always.

Mr Trump, of course, is no more a Republican than he is a Democrat - He's a Trumpist. As Obamacare collapses under its own weight, he will just sigh and say he gave it his best shot. The Democrats introduced it and the Republicans failed to repeal it.

The Telegraph informs us confidently that "the poor just did without" for decades. Please tell me, without what? I have made most of my living for the past quarter century providing in-home nursing care to disabled children, growing into young adults who will never even do their bare minimum duty, vote Democrat. People in Britain, from the Archbishop of Canterbury on down, pontificate on American health care without any mention of Medicaid, nor any of the other mechanisms we have devised, to pay for care for the health needs of the poor. Very few people are wealthy enough to afford the level of care provided for the poor and disabled. OTOH, we have enough of a vestigial free market left that ninety five percent of new drug trials in the world are done in five American hospitals. Government is not innovative. That's mostly a good thing, since 'innovations' by the government usually include things like "Deeming a bill passed" without the inconvenience of a vote. However, the wealthiest people in the world are beating a path to our doors, to get state-of-the-art treatment. Yes, they come to London and Switzerland, too, in fewer numbers, but they do come. They come to the private doctors and hospitals, not to the "free" NHS.

And before someone chimes in with the Leftist party line about lower life expectancy, we count every newborn who makes a respiratory effort as a live birth, even if she only makes it for another hour. Babies who live less than a day, pull down the average of life expectancy for those of us who make it to sixty six, or eighty six, for that matter. The science of neonatology was invented here, a great deal of it in Texas. Without it, those babies would count as miscarriages, very sad, but, well, that's Nature's way.

The Democrat party, more truthfully, the party of Control and Corruption, has snaked its tentacles into so many aspects of American life over the past hundred and five years, that Obamacare was just their natural next step. If we can cut the tentacles out, like removing the roots extended by a melanoma, and they can be prevented from growing anew from the remaining fragments, we might be able to start the American experiment afresh.

To Mr Trump. It's a huge task, Mr. President, but we are counting on you.

Michael, like I said, it will take defeating Democrats the whole way. Good post.

Tim Stanley makes some relevant points, but misses important aspects of the health care controversy in the US. First, despite its nickname "Obamacare" originated in the conservative Heritage Foundation think tank and was first implemented in Massachusetts by then-governor Mitt Romney, a Republican. It is an attempt to have market forces decrease costs while providing wider availability. The Democrats thought they would get cooperation from Republicans by passing it as a first step toward "Medicare for all". They did not.

Many Americans have very short memories. The Affordable Healthcare Act (ACA) didn't pass because of some dastardly left wing plot. It passed because our obsolete system of employer-sponsored healthcare, designed for the post-war boom, had failed and was leading the country to bankruptcy. Before I retired 10 years ago I had what is currently called "Cadillac" health insurance, meaning "the best". It was a nightmare. There were weeks my wife spent 20-30 hours on the phone trying to get bills covered, and all the while the costs to my employer and myself were rising while coverage was shrinking. My story is in no way unique, and I'm happy to be on Medicare now.

There's a reason all other advanced countries in the world have government-controlled systems: They deliver generally superior results for half our costs or less. They have their own sets of problems, but they're less severe.

Stanley's right that the failure of "Trumpcare" isn't all due to Trump. Paul Ryan, the Ayn Rand cultist, is at least as responsible. He tried to sell everyone a bill of goods based on the rantings of a drug-addled writer of cheap potboilers. American Libertarianism is completely unworkable, and nothing will change that. The "freedom caucus" shares the daft religion of marketplace as all-knowing god.

If the Republicans stay in their current mode the next bill they'll introduce will require all roads, bridges and tunnels built after 1959 be dynamited because everything was better back then.

President Trump promised to repeal and replace 0bamacare. Everyone should know, however, that the President is the head of the Executive Branch of the Federal Government, not the Legislative Branch (Congress). This means that he promised to urge Congress to legislate the repeal and replacement of 0bamacare with an improved (how could it not be improved?) healthcare plan, which the President would sign into law if he deemed it satisfactory.

As promised, the President convinced the Speaker of the House of Representatives to introduce such a bill, which is the first stage of the legislative process. The bill, however, failed to receive a majority of support -- none of the Democrats and fewer than the requisite majority of Republicans supported the bill. That was the bill's demise in Congress.

In my humble opinion, this whole process, except for Mr. Trump's honest promise, was a political charade. The Democrats continue to be recalcitrant assholes -- they cling to what they believe to be 0bama's "legacy legislation", which everyone knows has been a disaster from start to finish. Those Republicans who withheld their support presumably think that a better redesign of the healthcare system can be accomplished after 0bamacare implodes from its massive deficiencies.

The American public has not been well served by its "People's House". The Members of the House will have to face retribution from the electorate in 2018. And, the beat goes on.

What TBH succinctly says above;

"In my humble opinion, this whole process, except for Mr. Trump's honest promise, was a political charade."

I also, in my likewise "humble opinion" totally concur with.

We 'on this side o' the pond' recognized as quick as Mssrs McConnell (especially & notably) & ... just about, every other Republican ran on the theme "The first thing we'll do if, since y'all gave us the House back in 2012 do, the same for us in the Senate come 'round 2014."

And thus it, the compact was made so.

But then a bunch of other stuff became more pressing - getting young, *educated*, white women and, "undocumented" [illegal] immigrants to pull the lever for the *Conservative Republican* being, among others, something that'd take extreme finessing, proved "difficult" given what's so far been within the talents of 'our Elites.'

http://www.csmonitor.com/USA/Elections/Senate/2014/0625/How-Mississippi-Democrats-and-GOP-bigwigs-helped-Thad-Cochran-win

TBH ... again expressing my own "humble" opinion, sees accurately that, instead of just a whole bunch of trees goes along ways off - there's actually a fuckin' forest.

The Massachusetts health system got its start before Romney.

Excerpt 2012/09/21 Washington Post.

Way back in 1985, under then-Gov. Michael Dukakis, Massachusetts set up a program called the Uncompensated Care Pool. Much like the name suggests, the pool is used to finance health care for those without insurance. Massachusetts financed the plan largely through assessments on hospitals and insurers. Under Romney's administration in 2004, each industry paid in about $157 million to keep the pool running. That plan still operates today -- under the name Health Safety Net - and covers health care needs that Massachusetts residents cannot afford.

Since the late 1990s, Massachusetts has also received additional Medicaid funds to enroll populations that other states traditionally do not cover. In 2005, when Romney was governor, the federal aid amounted to $550 million. As former Romney adviser John McDonough explains in his book "Inside Health Policy," the funds were crucial to laying the foundation for universal health coverage. He takes us back to 2005, when the George W. Bush administration was getting ready to end that special funding arrangement:

"In Massachusetts, $350 million is a lot of money, and the news set off alarm bells. Governor Romney reached out and formed a partnership with Senator Kennedy to scheme how to keep the extra federal dollars coming. At that moment, the state's mundane desire to retain federal dollars merged with the policy goal of universal coverage to create a new policy imperative. Romney and Kennedy proposed that Massachusetts keep receiving the extra payments and in return the state would shift the use of those dollars [to] subsidies to help lower-income individuals purchase health insurance coverage."

End excerpt. Bolded by myself.

In short every U.S. tax payer helps fund Massachusetts health system.

The law was amended significantly in 2008 and twice in 2010 to make it consistent with Obamacare. Also, major revisions were passed in August 2012, and in 2013 in favor of the federal mandate.

Massachusetts did not levy a tax on insurance companies and makers of medical devices; the Massachusetts law has no similar provision, whereas Obamacare does.

An short addition to the above post.

Also, as of December 2011, the state secured $26.75 Billion in federal funds over the course of three years. It will, among other programs, continue to finance the universal coverage program.

"A lot of the ideas in terms of the (health insurance) exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, that originated from the Heritage Foundation." — Barack Obama on Tuesday, March 30th, 2010 in an interview on NBC's Today show

This is rated mostly true by Politifact. The ACA is not exactly like Massachusetts' plan, but both originated from Heritage Foundation ideas among others:

"Did Heritage originate the idea? Our research suggests that while Heritage has advocated for health insurance exchanges for many years, others did, too. Scholars credit Alain C. Enthoven -- an emeritus professor at the Stanford University Graduate School of Business who worked in the Defense Department during the Kennedy and Johnson administrations -- with popularizing the idea for an exchange as many as three decades ago.

Still, there's little doubt that Heritage has been a consistent and eager promoter of the exchange idea, especially during the effort to design a new health care system for Massachusetts. That effort concluded with the Democratic legislature joining with the Republican governor, Romney, to implement a system that includes a health insurance exchange.

On numerous occasions, Heritage scholars wrote approvingly of the exchange system in Massachusetts, known as the Connector. In a paper about the Massachusetts plan published on April 11, 2006, Edmund Haislmaier, a Heritage fellow in health care policy, wrote of the "truly significant and transformative health system changes that the legislation would set in motion."

http://www.politifact.com/truth-o-meter/statements/2010/apr/01/barack-obama/obama-says-heritage-foundation-source-health-excha/

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