It appears as if the repeal is going to be piecemeal, rather than simply toasting the entire thing as on
(Washington Post) The Senate voted 51 to 48 early Thursday to approve a budget resolution instructing House and Senate committees to begin work on legislation to repeal major portions of the Affordable Care Act. The House is expected to take up the legislation Friday.
Senate Democrats made a late-night show of resistance against gutting the Affordable Care Act by forcing Republicans to take politically charged votes against protecting Medicare, Medicaid and other health-care programs. The measure narrowly passed without the support of any Democrats.
The hours-long act of protest culminated in the early hours of Thursday when Democrats made a dramatic display of rising to speak out against the repeal measure as they cast their votes. The Democrats continued to record their opposition over their objections of Senate Republicans.
Funny, they didn’t stand up for it when it counted, namely, during election season. Only a handful of Democrats campaigned on it in 2010, 2012, 2014, and 2016. Most wanted nothing to do with discussing it.
Sen. Rand Paul (R-Ky.) also voted no, in part over concerns that GOP leaders have not committed to a plan to replace the Affordable Care Act after it is repealed.
He is correct. There needs to be a replacement plan. But, what if the GOP votes to repeal certain portions, such as the Mandate? How would Democrats vote, putting themselves on the record?
Republicans blocked six amendments from Democrats within the first several hours of voting. Among the failed measures was an attempt to prevent any changes to Medicare or Medicaid, or to reduce the number of people enrolled in private health insurance.
Democrats tracked how Republicans voted throughout the night — information that could be used during coming election campaigns, according to Democratic leadership aides who would not speak on the record to divulge internal party strategy.
Well, that’s interesting. Why did they not do that during the previous election seasons? Sure, Leftist groups campaigned on it a bit, but not Democrats up for election.
Republicans have at least a dozen plans for replacement. Trump says he has a very specific one of his own. Let’s get the details down before going ahead. There’s nothing wrong with that.
The ACA is national health insurance and as such without the mandate it becomes an entitlement unless you repeal it in total.
IF you guarantee that any and all people can be covered regardless of pre-existing conditions, what’s to stop a person from not paying in until they get sick? Maybe a penalty payment for not taking part?
Jeffery makes an excellent point about preexisting conditions. This is health insurance and like any other insurance it is there to cover possible future loss but not a current one. You can’t buy preexisting homeowners for a burnt down house. Insurance companies don’t buy claims and shouldn’t be expected to.
I think one way to cover preexisting conditions is to have a high-risk pool funded by mandated contributions from the insurance companies and some sort of government subsidy to help.
Most, almost everybody in America can be covered by a combination of Medicaid, Medicare and private insurance. Plus, it gives the vast majority of us the right to choose the type of coverage we want and can afford. What needs to be done is to open up the private markets by allowing one to own his insurance, move it with him, remove it from employment, allow it to cross state lines and stop with stupid mandates for “everybody” like maternity for men and making every policy pay for sex changes or liposuction or not medically needed abortion or birth control. We can respect peoples rights and faiths and still have insurance.
The mandate is another form of welfare…..
The only way to truly make healthcare reach everyone effectively is a combination of private and government sponsorship in which companies, corporations and individuals all pay for their health care.
Medicare reduced to 60 percent coverage…..Supplemental insurance sold by the insurance companies that cover the other 40 percent…….Drug coverage….and a pool in which the high risk individuals are covered by the government with payments coming from the Government, Insurance, companies and individuals.
This needs to be a group/collective effort in which everyone contributes….
The problem with the ACA is that it is so much more than a prod to make people have insurance. It is totally and completely invasive into every aspect of your health and well being. It separates you from direct care by an educated, licensed physician in the form of bureaucracy and mandate of care by “cookbook” developed by Federal rules and the opinions of academics (which are basically 100% wrong). Your doctor is further controlled by a body of administrators and the only way to continue a practice is by joining a “quality” assurance group. As with affordable medical care the law has nothing to do with “quality”. The other thing is that all insurance has been affected by this law and so common means of evaluating patients, such as stress test, are not allowed because of “peer” review of a request for testing which is nothing more than the insurance company assuring that the procedure can not be preformed secondary to bureaucratic paper work. To get anything done, I have to talk to a nurse or doctor in another state who is hired as they can’t get work elsewhere due to drug use or stupidity. Those are the ones making key decisions about your health. This was present before, but now is the rule of thumb. Example, a patient comes to me with unstable chest pain and high risk for CV disease, a combo that assures a MI in 6 weeks. Insurance company turns down request for testing (cath). This occurs constantly and is a product of the ACA. And no Jeff, you have no idea as to what is in the 17,000 pages of law.
At the end of the day, to make medical care affordable, as the government, you make sure people can not get care. That is what occurs in all socialized medical systems. What made Canadian insurance great to the user was that they could come to the US for care and avoid the state run road blocks. The ACA is showing that it is just as bad, if not worse than what we had told everyone. Oh, I might add that I get paid better under the plans so I am not compromised by wanting more money (another means by which Jeff denigrates ones opinion).
Do we need changes? Yes. Basically require insurance companies to offer product in all states, once you have paid into the pool, your pool can transfer without problem. Require that the real drivers of health care cost, such a Jeff and his company, are held accountable for the excessive cost of their product. Eliminate the FMD as they are higher billers and have not need here. Reduce the number of doctors, assuring reduced cost and better quality of care (medical system is the reverse of the Adam Smith model of supply and demand).
Guaranteed coverage for people who cannot pay for health insurance, regardless of how it is structured, is welfare.
I think that I’ve been the only one with the balls to say it in public: if you cannot pay for health insurance, you should not get it, even if that means you die due to the lack of health care.
I think that I’ve been the only one with the balls to say it in public: if you cannot pay for health insurance, you should not get it, even if that means you die due to the lack of health care.
Yeah? No. There is nothing wrong with welfare for the needy. There are people who are needy….what about the person who you claim should never be aborted but who is severely handicapped with massively expensive healthcare needs? Let them be born only to watch them die?
There are many people who need handouts and welfare….when we as a nation start telling people to work or die……there would be a lot of dead people under Obama’s watch…..would there not?
Your statement makes zero sense.
Liam and Dana,
There might be merits in both your points of view.
For thousands of years, people got along without health insurance. If you needed to go to a doctor, you either paid, found a group of people that would help you pay, or barter for the services. People who did not have what we call today “health care” managed to live and do quite well because there were options other than government mandated options.
My grandfather was an undertaker. He would literally take people in, perform services and if people didn’t have the ability to pay, he would work out an agreement for the services. You literally cannot do that today as employment laws prevent you from bartering for services. So in the end, instead of people looking out for themselves, they now look to the government – the very group that caused most of the problem to begin with.
At the same time, Dana’s point carries some weight as well. Why should other people be forced to pay for something that you are unwilling or unable to pay for? Furthermore, where is the line drawn at who is “needy?”
The fact of the matter is that people should look out for their own interests. Not to the point of being selfish, mind you, but we condemn insurance companies for making money for their stock holders and yet we ourselves want more money in our own pockets. david’s post above shows that problem as well. He has long criticized the government for interfering in his profession, yet his post indicates he wants the government to mandate what companies must do. His post essentially states “I want the government out of my profession but I want them in other professions.”
One more thing….. the left often says things like “we pay twice as much and don’t get a benefit.” That’s not quite true. We do get better results and more importantly to some people, we get better results now. By that I mean wait times in other countries are far greater than here in the US. That ability to have care and have it at this moment has an associated cost to it – one that is seldom factored in.
gc
No I want the government out of everyones lives. The problem is that the government has set up winners and losers. Currently Jeff and his bunch enjoy perks that enrich them. This must stop.
For the rest,
Louisiana used to have a system that worked. That is amazing in my state. What happened was that there were two worlds. Those who were poor went to the state hospitals were they recieved good free care. This meant wards and wait times and student doctors. If you could pay, you went to theprivate hospitals. As youcan imagine this drove the liberals nuts so they stopped it and we now can not afford the taxes.
david:
Perhaps you didn’t read what you wrote or don’t remember it:
Do we need changes? Yes. Basically require insurance companies to offer product in all states, once you have paid into the pool, your pool can transfer without problem. Require that the real drivers of health care cost, such a Jeff and his company, are held accountable for the excessive cost of their product. Eliminate the FMD as they are higher billers and have not need here. Reduce the number of doctors, assuring reduced cost and better quality of care (medical system is the reverse of the Adam Smith model of supply and demand). (emphasis mine)
If you are demand the government require (your word) businesses act in a certain manner, that companies price in a certain manner, and restrict people from entering into a profession, that is not having “the government out of everyones lives.”
gc
Again you are too smart for me to hold a discourse, I am in awe. What you and Jeff dont understand is what we want in our overbearing governmental atmosphere, versus what we truly want in a better environment. If you want to discuss an issue and nt me then let me know.
david,
I am just going by what you wrote.
When you say “better environment,” what you really must mean is a “better environment” for you as you are advocating for more regulations on other businesses and for suppressing freedoms of others to enter into the marketplace.
How about instead of arguing we accept that in a nation of 330 million people any industry is going to have some regulations? May we agree on that? May we also agree we would like to see the least amount of regulations necessary and those regulations should come from the lowest level of government capable of doing so?
For example, the federal government should determine that an insurance company may sell the same or similar policies in all the states and that all policies must be moveable by the insured. The state will determine which companies it will permit to operate within its borders. The company will decide what coverages it will offer in each policy.
Hoagie,
All but extremists at either end of the spectrum agree with you that some degree of gov’t regulation is not only desirable but necessary. Quite valid arguments about how much regulation is optimal form the basis of much of our politics.
Regarding healthcare, all other 1st world nations have devised any variety of functioning systems that serve to deliver healthcare coverage to all their residents for much lower costs than America.
The PEOTUS promises better healthcare at lower costs for all Americans. We can’t wait to hear his plan.
I understand that Jeffery, but they are dealing with 30, 50, 60 million mostly homogeneous people. We are dealing with 330 million people of all races, religions etcetera. We have many more problems and accommodations that need to be made than they do and we have a Constitution that’s been interpreted to mean everybody must be treated the same even though all these different races, religions and ethnicities are not the same.
We need to come up with an American plan and we can’t do that by constantly repeating over and over about how great the plan is in the Netherlands or Korea. They are irrelevant regarding any plan that would fit our needs. Wal-Mart’s group policy covers more people than The Netherlands and the 50 million Koreans all eat the same food, breathe the same air and live in the same climate. Generally they all have the same medical problems.
BTW, many countries have lower costs than we do on many things. They also have higher costs on many things than we do. Their costs are based on their economy and the price they must generate to deliver “X” commodity. Ours is based the same way on our costs. We can compare the price of an item based on it’s current cost but there is zero relevance to it’s cost in Dubai.
So if you really want to discuss solving the health insurance cost problem and the health care delivery infrastructure you need to hold that liberal impulse to compare irrelevant foreign systems to ours in check and concentrate on devising a system that will work in America for Americans and with the quality and cost we Americans want.
That means don’t worry about what the Dutch are doing. Worry about us.
The problem is Hoagie that the definition of “least amount of regulations” is going to vary from person to person.
Some would argue that regulations should require what is covered. Other would argue that the least amount of regulation would be an ala carte selection.
Even your hypothetical federal regulation of requiring a company to honor policies across state lines runs into trouble when you say that the states should license who they want within that state. Would a self insured group have to extend across state lines? Wouldn’t requiring companies to go across state lines mean that only the largest insurance companies could handle that burden? Wouldn’t that be an effective barrier into the market place? What do you do with insurance rates from one area of lower health costs to another area if higher health costs?
My point was, is and remains that people will advocate and push for things in their own self interests. Doctors will. Drug companies will. Insurance companies will. Individuals will. Companies will.
My only real argument in this case is “don’t sit there and try to say that people aren’t looking out for themselves first” (in both costs and regulations.) That just doesn’t fly.
The GOP wont fix this…..they have this stupid idea that health savings account and insurance sold across state lines will all of a sudden make insurance companies responsible and not gouge the customer.
As Ive often said here….why does it cost 10000 dollars to paint your car? Because 95 percent of all paint jobs are paid for by insurance companies that dont care how much it costs….they simply raise rates and a captive audience WHO ARE FORCED TO BUY INSURANCE….have to pay it.
So the GOP will throw down two stupid ideas…claim they fixed health care….the industry will go back to gouging the Insurance industry and the prices of health insurance will go up….but this time the corporations and companies who have put everyone of 34 hours a week will not pay for their healthcare……
Why should they…..they quit under Obamacare unless your a huge corporation…..why should they suddenly want to digest those huge employee costs by picking up the tab for healthcare??
They wont….there is no way to fix this problem without a serious effort…….the ACA FUBAR’ed the health care model in this country and no theres no going back…..only changing directions.
So the GOP will do a few retarded things…….pat themselves on the back…their whacko tea party base will shout hallelujah and then they will lose 40 house seats and 10 senate seats in 2018 and then Trump will be impeached and the Democrats will be back in charge……..
Because once again the right this time…..Lied their way all the way to DC and will duplicate the lefts retarded idea of how to rule……and the end result is Americans will suffer and the GOP will get tossed out on their ear.
I am remarkably astute in smelling the winds of change….I pride myself on that….I can see this coming. Its so apparent in listening to GOP Senators and Reps during interviews…..They have no plan to do anything trump wants done other then cut taxes, cut regulations and repeal obamacare…..a 3 of which will get them fired in 2018.
GUARANTEED!
What you say Liam may be completely true but what I’d like to discuss is how to do a health insurance/health care system in America that works, not the stupidity of the Republican Party which is already well documented.
Gitarcarver, I understand people will be “looking out for themselves first”. Enlightened self interest is only human however, you seem to think that it excludes all responsibility toward others. Just because I want to feed MY family first does not mean I want yours to starve. Likewise, because something is good for me or my family does not necessarily make it bad for you and yours.
Now I don’t have much time but let me try and address some of these:
Regulations should not require what is covered since all people don’t need or want the same coverage. That’s like requiring a restaurant to require everyone to by a coke even diabetics or people who want coffee. Different companies, different policies, different coverages. Variety for the consumer. Problem?
1. Not at all. If a company is licensed in a state that means it can sell policies in the state not that people who have policies from other states aren’t covered. That’s the way it is now.
2. No, only the coverage to their insured.
3. No.
4. Charge accordingly. What do they do for any other commodity that costs more in Frisco than in Boca? Charge more in Frisco!
Gotta go.
Poppycock. I never said any such thing. What I do believe is that what is “freedom” for some is oppression for others – an idea that enlightened people have held for millennium. Secondly, there is that point that there is a difference between responsibility to others and government mandated “responsibility” (an undefined term) to others.
So my point stands. What “minimum regulations” are to you are not the same as “minimum regulations” to others. What you seem to not understand is that until we define terms, one can’t have constructive discussions.
Using your numbering system, let me respond:
1) The company, even if it is out of state, still must be licensed in that state to sell and collect policies and premiums. In Florida, for example, the company must have a physical presence in the state in order to sell insurance here. Your proposal was for the Federal government to require all companies to be within all states but then say that states should license those companies or not. There’s a conflict there. Furthermore, while you want people to be able to pick the coverage they want (and I agree) I don’t agree with forcing companies to operate in states where they don’t want to or cannot financially do so.
2) In your last post, you wrote:
In your post of January 12, 2017 @ 7:15 pm, you wrote:
To be frank, there may be some confusion as to the term “self insured.” I was talking about the new craze of “self insured” or “self funded” insurance where a group (such as a company or municipality) decides to partner with a local hospital and actually builds a clinic / health care center. The covered people go to that clinic. How does that fit with the idea of “taking insurance with you?”
3) I’m sorry, but do you really think that the required Federal mandate of insurance in all 50 states and the state licensing is going to be cheap? You don’t think that a huge outlay to meet that requirement is not a barrier to entry into the market? No offense, but I think that is rather shortsighted.
4) That would be the solution except that one the Feds step in, 14th Amendment issues arise. Even now there are cases working through the courts on the ACA charging different rates for the same coverage. It is an issue that will have to be addressed if the Fed stay in this.
1. Medicare for everyone.
2. Fully funded medicare in which the payouts are UPPED significantly.
3. Medicare pays 60 percent of all bills.
4. Private insurance must be purchased….that pays a full 40 percent that Medicare does not cover.
5. Payments are made via the employer, employee and the government.
6. Out of pocket costs are zero.
The funding for this program would by via Companies/corporations paying healthcare as a benefit….however their costs would be reduced because they only have to pay for plans that pay only 40 percent….
The employee would begin paying medicare premiums which would escalate with age up to but not to exceed a figure deemed acceptable….I envision…50 bucks a month for a 18-29 year old…75 for a 30-45. 125 for 46-59….175 for 60plus…
Right now most seniors are paying 110 for medicare and around 160 or so for a supplemental…..I forsee this as a template with the caveat that the Employee kicks in their contributions in the form of health care premiums paid to the federal government which then disperses the premiums to the existing pool of health care insurers based upon a per state cost of doing business.
Along with the contribution of the Federal government we now have a health care system that is Universal health….but is privately funded and private insurance companies can still make money, are not liable for huge expenses and have no need to gouge their customers because the system is designed around a more liberal, ie generous Medicare system in which doctors and hospitals could actually afford to work, make money as long as they watched their P’s and Q’s and didnt hire 15 people for one doctor.
It could very easily work…..would require the participation of everyone and would require the government to regulate it…..regulations are a good thing if they hold the best interest of ALL parties in mind and not one side or the other.