22 Million More Uninsured Under Senate GOP Health Care Bill, CBO Reports

Buzzwords 

thom's side has been winning...america is almost great....any day now.

The play here to be concerned about is the few senators who are currently saying they will NOT support the bill "in it's current state". They can make that comment to cover themselves later ("I came out against it") when the shit hits the fan. What happens now is that as noted above, there will be incredibly meaningless "tweaks" which will potentially sway just enough of the current naysayers to get this thing passed.

A few things to recognize:

Many people (healthcare consumers) do not understand their coverage, etc. Yes, Mr. Trump, it is complicated. Think about the potential for lapsed coverage in today's fast moving, job changing, transient society. This is where people will pay the penalty which will be more than the ACA's penalty for not buying insurance, but more importantly, it's where people with pre-existing conditions will get royally screwed.

GOP has already taken to their newfound approach of just blatant lying. Hell, it worked to get his orangeness elected, why change now? "It does not cut Medicaid", "It covers pre-existing conditions", etc.

Until or unless the GOP moves away from their hard on to repeal the ACA, they will end up taking large heat down the road. Again, healthcare is complicated. There's huge money in it. Big pharma, medical devices, etc. all employ many people with nice compensation (used to be one myself). Execs in those spaces make extreme $$$$ (drive around the big pharma towns in NJ and PA to see the wealth on display). Mess with them and it's a political issue for you (see pol's on both sides of the aisle on regulating Rx pricing). Haven't even discussed the insanity of the health insurance market itself (see CEO wealth there). What we should have learned from the ACA was that it isn't and never was going to be perfect. After living with any big piece of legislation, you get to see the things that need to be tweaked. Good government practice would call for both parties to keep the good parts of the ACA going and work towards fixing the negatives.

The point of the above is that if the GOP continues on their current path and we end up with whatever the fuck they're calling their plan (Death Squad Force), we all must expect to run into the same issues. In X years, we will have some good and some bad. In the meantime, the transition and resulting mayhem to transition will be chaotic and will cause people who are suffering with health problems to suffer further. It just will happen. Unfortunately, but for political purposes, it doesn't have to.

One other thing: if you are fortunate enough to have your healthcare provided via your employer and thought (like many have and understandably so) that much of this debate probably wouldn't affect you, well, that may not be the case. If you work for a company that operates in multiple states, buried in the bill is a clause that allows companies to choose a state from which they can offer a policy to ALL of their employees. The issue here is that the bill is allowing states to make decisions on how they want to fund plans and what plans they will allow. That means we will end up with a bunch of differing policies across the nation. Companies, who are always looking for ways to cut costs. Healthcare is a MAJOR cost to companies. It is not a reach for them to research which states allow them to offer the cheapest (to THEM, not you) policies. This can take the form of premiums and coverages. So, you could work for a company that today offers a nice insurance package at a reasonable cost to you and wake up next year with something very different.

so who do the dems run in 2020? 

theyre looking pretty god damn awful atm. do they even really want to win? shits a mess. 

the  GOP is a mess - and god damn awful. They cheat though, and win. And for some crazy reason, Americans continue to vote against their own self interests and support the party of Scrooge and the Grim Reaper. Or some idiot spoiler candidate like Ralph Nader or Jill Stein. Fuckers still can't bring themselves to admit that Hillary Clinton and the Democrats would be far better for America..and American's health than the GOP. Good news is that Barack Obama seems to be willing to speak up and might motivate the voters to get out and VOTE for Democratic candidates who will once again clean up the mess left behind by the GOP. 

yeah, they literally have no one to stop the trump train.

at this rate, they'll prop up hrc to run again, lol. the democratic party is in shambles. sad.

Yeah..nobody at all. If you discount Elizabeth Warren, Kamala Harris, Wendy Davis, Sally Yates, Kristen Gillibrand, Amy Klobuhar, and maybe even Michelle Obama. Probably a few good men, including Joe Biden. Gavin Newsom. 

Sad? Yeah, you sound pathetic. 

sally yates is interesting. so more corporate dems? that'll get the progressive base to show up, lol  fuuuuuuuck  

sorry, trump destroys the rest, not even close. 

>>>> Or some idiot spoiler candidate like Ralph Nader or Jill Stein. Fuckers still can't bring themselves to admit that Hillary Clinton and the Democrats would be far better for America

Lol. Do you live in California? 

Not inspired by Nancy's list of candidates/alternatives to Hillary/Bernie either.  The Democrats need their next Barack Obama SofaKing badly right now . . .

https://en.m.wikipedia.org/wiki/List_of_United_States_state_legislatures...

Add Al Franken and... Oprah that list,  If you're looking for celebrity. Colbert / Stewart would be a dream team

>>>>>Not inspired by Nancy's list of candidates/alternatives 
 

you gotta remember her POV is in the minority. that's a pathetic list to choose from and anyone from that list would be soundly rejected by the majority of people outside of CA. Biden is viable, just don't think his heart is in it anymore. hell, he most likely would have won the last election as long as the DNC didn't collude to ensure hrc was the candidate.

2 party system is for the sheeple.

''My entire life, I've watched politicians bragging about how poor they are, how they came from nothing, how poor their parents and grandparents were. And I said to myself, if they can stay so poor for so many generations, maybe this isn't the kind of person we want to be electing to higher office,” Trump told Dowd, adding, “How smart can they be? They're morons.”

They need to really excite the minority/woman base/vote, or the racist old white rust belt working class folks.  Or preferably both.

>>  If you work for a company that operates in multiple states, buried in the bill is a clause that allows companies to choose a state from which they can offer a policy to ALL of their employees. The issue here is that the bill is allowing states to make decisions on how they want to fund plans and what plans they will allow. 

This is already the case for my company. They operate in multiple states and everyone gets insurance from the same one (not the one I work or live in either).

The other missing component to all of this is the fact that as a society, ultimately, we do provide healthcare to all who need it and come for it. People in emergent situations are not turned away which is what being human is all about.

So, what happens? We all end up paying for that one way or another. What the ACA was looking to do was to make that more palatable to all with one of the ways being adding tens of millions to the paying component of insurance.

Between the GOP's House and Senate bills, the average estimate of those who will lose coverage is 23 million people. That's a shit ton of people who will no longer be paying into the insurance pool, but when those of that group need emergent or other care and get it, those costs will be spread amongst less people who will therefore, have to pay more.

The other detriment applies to those who do get care and don't have insurance and can't afford to pay out of pocket. While we all pay for that care, they get swamped with massive debt often resulting in bankruptcy, etc. which then puts them into the "safety net" which we, as a society, agree to help. It's a massive double dip against all.

"We've got to stop riding in limousines," Sen. Al Franken (D., Minn.) said Monday on MSNBC's "Morning Joe" when asked how the Democratic Party could change the stereotype of "limousine Democrats."

The comment came after MSNBC contributor Eddie Glaude asked, "How do you change the view that the Democrats are just simply limousine Democrats, that the party is in the hands of Wall Street?"

Franken's answer resulted in laughter from the panel, who, as Mediaite noted, are possibly quite familiar with being inside a limousine.

Franken then redirected the discussion to how people wealthy enough to be in limousines often should not get a tax cut.

The term "limousine Democrats," or "limousine liberals," is a derisive one for wealthy left-wing politicians or pundits who speak of concerns for the working class but still live a rich lifestyle.

Dems are clearly not taking advantage of any of this mayhem. Their disarray should not be shocking based on how they f'd up the approach to the Presidential campaign (HRC picks Bernie as running mate, they get the vote out and may have beaten the Russians er Trump).

They should be spending a fortune to create and own the narrative that the GOP plans are the true "death panels", etc.

No leadership.

As an independent who abhors the current so-called President (no redeeming qualities of any kind) and the complicit GOP, I unfortunately need the Dems to get their shit together and at least be in a position to kick the can down the road apiece until sanity comes back in to our collective mindsets.

Ironic that John Q Lunchpail has Disdain for "Limousine Democrats" while downright Worshipping "Limousine Republicans"  That's a huge hurdle the Dem's are gonna hafta overcome somehow.

I guess Limousine Republicans are not seen as Hypocrites - they are blatantly evil & greedy all out in the open-like . . . 

Unless or until I am convinced to support another candidate - Warren/Booker 2020!

..

HEY ZONAHS - PLEASE TAKE TIME TO READ & THEN CALL YOUR SENATORS! THANK YOU, PEACE & NAMASTE!  

CBO: 22 million fewer Americans would have insurance under Senate health care bill - Updated by Dylan Scott/ Vox

https://www.vox.com/policy-and-politics/2017/6/26/15875528/cbo-score-sen...

SARAH KLIFF BREAKS IT DOWN SIMPLY HERE!

Page 48 is the most important page in the CBO report - Updated by Sarah Kliff / Vox

https://www.vox.com/policy-and-politics/2017/6/26/15876476/voxcare-cbo-r...

Graphic below: Javier Zarracina / Vox 

CALL YOUR SENATORS AND TELL THEM TO VOTE NO ON THE BETTER CARE RECONCILIATION ACT! 

ARE YOU ON THE PHONE YET? 

Call 888-865-8089 and tell your Senators that you will remember who took away health care from millions of working people. (If no one answers, leave a message.)

At this point we should call it "healtchcare". Those coverages were pathetic and really they were hardly covered. The healthcare system in his country is just discgraceful. It will get worse, but it has been abysmal for a long time now. People are hustling healthcare harder than cigs or alchohol. It's supposed to be something that heals people and it's been turned into nothing more than a pimp with a cane calling the shots and collecting his dues. Shameful, disgraceful, inhumane, you pick the word.

Warren: Booker? Is that really the best the Dems have? Trump would eat them up for breakfast. They wouldn't get the funding they need just like hildog. They wouldn't win Ohio or Florida. Dems knew the stakes before. If they think popularity in California and New York will help them, it won't. The Russian narrataive will backfire on the Dems and propel trump to a second term. Dems getting played by Paul Ryan and Co. It just looks like an absolute ass whooping right now I mean come on. As much as I disagree with republican morals and politics, it's no secret that they are straight up whooping some ass right now, unfortunately. Just a fact. Dems have nothing and they are falling for an old school rope a dope that Trump has set up with the Russian narrative. It's sad to watch it unfold. 

I always skip posts that are in multiple colors and fancy script.

So it's actually gotten to the point where any attempt at entitlement reform is met with howls of: "They are killing people!!!!!!!"

Way to have a constructive conversation on one of the most important fiscal issues facing the country.  It says a lot about the quality of your argument that this is what you have to descend to.

CBO numbers are worthless.  They got everything about ObamaCare wrong and they will get everything about this wrong.  And that's not even taking into account the fact that the vast majority of uninsured people will be that way by choice because they are no longer required by the government to purchase a product that they don't want.

I know, Thom, you believe that folks like Buffet deserve the $600,000+ tax cut. 

Health care makes up 1/6 of the US economy, and hospitals are the largest employer in many rural counties. These residents of thrse counties will not only see access to health care services limited, they will experience a spike in unemployment.

https://theintercept.com/2017/06/27/cnn-journalists-resign-latest-exampl...

In 2013 CBO predicted that 24 million people would be on the exchanges in 2017, but only 9.5 million are now enrolled.

If 15 million people were to immediately drop coverage next year due to lack of penalties, then they are only buying insurance today to avoid the penalty.  The insurance itself has little value to them. CBO's conclusion reflects the mindset of state planners.

In reality, people buy insurance for a basic reason — they want the coverage.  They buy types of insurance that they are not forced to buy, such as life insurance, renter's insurance, and home and auto insurance above state mandated levels.  They want peace of mind and protection against unpredictable expenses.

State waivers in the Senate bill will make it even easier for people to purchase coverage.  States will be able to approve policies that are closer to what people want to buy, such as catastrophic health policies.

These types of policies are less expensive, and protect people against major expenditures but leave them to pay for routine costs out of pocket.

Remember those complaints when plans closed down? People will be able to get them back.

This will reduce the cost of insurance.  Under basic economics, less expensive insurance should have greater consumer demand.  CBO concludes the opposite, at least for 15 million Americans in just one year.

http://www.investors.com/politics/commentary/cbo-gets-obamacare-reform-e...

>State waivers in the Senate bill will make it even easier for people to purchase coverage.  States will be able to approve policies that are closer to what people want to buy, such as catastrophic health policies

Right  on, who needs coverage for maternity care, mental health issues, or drug addiction? Good luck with that Opioid addiction epidemic.

Trumpcare is all about providing billions of tax cuts to the ultra wealthy, sick and old people can suck it. AARP isn't exactly the most liberal organization, although not as liberal as Thom's link to investors.com. lol.

http://www.aarp.org/politics-society/advocacy/info-2017/senate-health-ca...

Senate leadership Thursday unveiled its version of a replacement for the Affordable Care Act (ACA), producing a bill that would allow insurers to charge older Americans extra for coverage while reducing subsidies and slashing Medicaid, which provides health care to 1 in 5 Americans.

The sweeping Better Care Reconciliation Act of 2017 also would allow states to waive important consumer protections including essential health benefits. This would allow insurance companies to no longer offer or drastically increase the cost of the coverage people need and depend on, particularly those with preexisting conditions. At the same time, the Senate bill would give billions of dollars in tax breaks to the health industry and wealthy individuals.

“This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debate — and it shows,” said Nancy LeaMond, executive vice president at AARP. “The Senate bill would hit millions of Americans with higher costs and result in less coverage for them. AARP is adamantly opposed to the Age Tax, which would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable.”

As it did with the American Health Care Act (AHCA), which the House passed in May, AARP vowed to hold senators accountable by informing its 38 million members how they vote on their health care bill.

Here’s a look at some of the key provisions of the Senate measure, which Republican leaders would like to bring to the floor for a vote before the July 4 recess.

Medicaid

The Senate bill would restructure the Medicaid program, which provides health care coverage for 74 million poor and low-income adults, children, pregnant women and people with disabilities. Medicaid also pays for long-term care services and supports, including home- and community-based care, and covers two-thirds of the care for people living in nursing homes.

The bill would phase out the additional federal funding 31 states and Washington, D.C., receive to expand their Medicaid populations. This phaseout would leave states with a huge deficit.

In addition, the Senate measure would cap the amount of Medicaid funding a state can receive for each person enrolled in the program starting in 2020. The bill also would give states the option of requesting a lump sum payment, called a block grant, specifically for adults who are not elderly, disabled or included in the Medicaid expansion.

These changes mean less federal money would be available to the states for Medicaid. Starting in 2025, the rate of growth of the per capita cap would decline significantly, meaning even deeper cuts to the program. Given the aging demographics of the country, the cap would not keep pace with the funding necessary to support the needs of the senior and disabled population.

Cost to consumers

Current law bars insurers from charging older adults more than three times as much for premiums as they charge those who are younger for the same coverage. Both the AHCA and the Senate bill would allow insurers to charge older adults five times as much, and states could receive waivers to remove even that limit.

The Senate bill also would make important changes to the premium tax credit assistance available under current law for those purchasing insurance in the ACA marketplaces. Under the Senate bill, the tax credits would cover a smaller percentage of medical costs. These tax credits would decrease as a person ages, meaning older adults would have to spend a higher percentage of their incomes on health insurance premiums. And many people who currently receive premium tax credits would lose them altogether. 

Essential health benefits

Under current law, all health plans must cover a set of basic medical services called essential health benefits.

These benefits include emergency services, chronic disease management, preventive and wellness services, in-patient and outpatient hospital care, pediatrics, maternity, mental health and substance abuse, prescription drugs, laboratory services and rehabilitation.

The Senate bill would allow states to request waivers to opt out of these essential health benefits. Allowing states to waive the basic benefits standards could mean that important coverage for people may not be available, including coverage depended on by individuals with preexisting conditions.

Elizabeth Warren is a sure fire loss in 2020.  And as far as Corey Booker, well, been there done that with Obama.

The Seth Meyers clip embedded in the link below is a hoot. and of course, so is Stephen Colbert:

https://www.nytimes.com/2017/06/27/arts/television/stephen-colbert-russi...

Stephen Colbert said he was glad to be back from Russia, where he spent four days taping what will be a week’s worth of “Late Show” episodes. While he was there, he announced on a Russian talk show that he was considering running for president in 2020.

“I thought it would be better to cut out the middleman and just tell the Russians myself,” he said in that interview. “If anyone would like to work on my campaign in an unofficial capacity, please just let me know.” But on Monday, he offered a slight clarification.

“To be clear, all I said in the clip there is that I was considering a run. If I decide to run, obviously I’m not going to ask the Russians to help my campaign. I’d have my son-in-law ask them.” — STEPHEN COLBERT..

<<And as far as Corey Booker, well, been there done that with Obama.

Plus, Dems are still pissed at Booker for his vote on the prescription drug bill.

Americans who tend to vote Democratic  are more pissed at Trump. Elizabeth Warren/Corey Booker would be way better for America than what we've got now. 

The Perfect candidate doesn't exist, so unless you want 4 more years of Trump/Pence, get real.

Well, yes, but I'm saying Corey has baggage in democratic circles.  He isnt a home run.

Not sure what you want me to "get real" about, Nancy, just making an observation. This isn't an argument.

I like the guy and happen agree with you.

JUDY WOODRUFF: As we have heard, a number of patient groups and major players in the health care industry have opposed the Senate bill. Every major hospital group has criticized it. They say they are especially worried about deep reductions in Medicaid spending for the poor and those with disabilities, changes that include new limits like spending caps or block grants that would eventually cut the number of people on Medicaid.

Hospitals say they will end up paying the difference by treating the uninsured.

While I was in Colorado for the Aspen Spotlight Health Festival last week, I spoke with Kenneth Davis. He’s president and CEO of the Mount Sinai Health System, which includes seven hospitals and more than 140 ambulatory centers and practices in New York.

Dr. Ken Davis, thank you very much for talking with us.

You were quoted recently as commenting on the House version of the Republican overhaul of the Affordable Care Act. You said it would have a fairly devastating effect on the country.

Is that the way you feel about the Senate version too?

DR. KENNETH DAVIS, President and CEO, Mount Sinai Health System: Absolutely.

I think, if anything, there are aspects of the Senate bill that can be even more problematic. Particularly, the glide path to per capita or block grants is going to produce a lower reimbursement for the states than was even in the House bill.

JUDY WOODRUFF: What about the effect on hospitals?

DR. KENNETH DAVIS: Well, there are a number of things that impact hospitals.

All of them collectively, particularly for hospitals that have a reasonable number of Medicaid patients, are pretty difficult. There are substantial cuts. For instance, the public hospitals — the Health and Hospital Corporation in New York City, they can’t possibly sustain these cuts to the Medicaid budget.

Other hospitals that have a large number of Medicaid patients have a very tiny margin. That margin evaporates with this bill.

JUDY WOODRUFF: And is that — even with tweaking, you’re saying there’s literally no way around?

DR. KENNETH DAVIS: Well, fundamentally, this bill is about decreasing Medicaid and decreasing what states receive for Medicaid and decreasing, in the House case, those who have the extended benefits or the eligibility that they previously didn’t have.

The bill isn’t that much around tweaks to Obamacare. It’s a little bit. It’s a bit to tweak the exchanges, but the money’s coming from Medicaid. And unless they take a completely different approach to Medicaid, I don’t see that tweaks are going to help.

JUDY WOODRUFF: So, there are observers of the health care system who look at all this, and they say hospitals are a big part of the problem. They’re consolidating. There are mergers. Doctors are cutting deal with hospitals. Everybody’s making more money. Hospitals are charging more.

What could hospitals do that they aren’t doing now to get some of these costs down?

DR. KENNETH DAVIS: Well, let’s remember all hospitals are not alike.

In many cases, geography is destiny in hospitals. So if you’re in a system like ours, in which the vast majority of our payments are either Medicaid or Medicare, that’s fixed. And the size of our hospital system isn’t going to change how much Medicaid reimbursement or Medicare reimbursement we get.

Additionally, as some systems have increased in size, they have done so in order that they can move away from fee-for-service medicine to what’s called value. To do that, to be a system that can take risk and value, you have to be large enough so that patients don’t escape your network. And that’s part of the thing that is driving consolidation.

JUDY WOODRUFF: Is enough being done, you think, to be mindful of costs?

DR. KENNETH DAVIS: Well, the margins in many hospitals are so small that, if you are not fixated on costs, you are bankrupt.

And in New York state, we have seen 30-plus hospitals go bankrupt in recent years.

JUDY WOODRUFF: So the lesson is?

DR. KENNETH DAVIS: The lesson is, we are focused on expenses. We have to be fixated on expenses. But what we really need to do — and we were trying to do this previously — and hopefully we can continue to do this — is ask, how can we deliver health care in a different, more efficient, cost-efficient way?

The system is failing us. The macroeconomics of health care are such that the government can’t afford it, the states can’t afford it, the employers can’t afford it, and the employees can’t afford it. What we have got to ask is, what’s wrong with the system and how do we change it so that it’s more efficient for everybody?

JUDY WOODRUFF: You brought up Medicaid. You were saying how much of this legislation is around Medicaid.

There are many who say that the Medicaid expansion that was part of the Affordable Care Act originally, which I know you were strongly for, the critics say this was simply throwing money at an inefficient program, poor-quality care, people on Medicaid don’t get the same level of care that others do.

And they point to studies showing that, even with the expansion of Medicaid, that that care is not getting much better. How do you respond?

DR. KENNETH DAVIS: Well, those studies or study doesn’t take a very long perspective.

You can’t see the difference in things like mortality for quite some time. If you’re lowering people’s hemoglobin A1c or better controlling their blood pressure, it can take sometimes years before you see an extension of a lifespan in those patients.

But what we did find, what was reported was an improvement in mental health. And it seems like people have forgotten that. The largest provider of payment for addiction services is Medicaid. Twenty percent of all Medicaid recipients, at the very least, have mental health problems.

To take that out of the equation is very, very destructive. And to think that we’re not having a positive influence — because the only thing we really directly affect and that we can measure short-term is improvement in mental health — is a little demeaning to our psychiatrists.

JUDY WOODRUFF: Let me go back to the mega-question about our whole — our health care system.

What conservatives are arguing, among other things, is that when you have health care, rising costs of health care driving at least a sixth of the economy, that something’s really out of whack, that the whole system is too expensive, too out of control. Government participating in it is helping to drive up those costs.

Do they have a point?

DR. KENNETH DAVIS: Not really.

We lose money on every Medicaid patient who walks through our door, whether it’s inpatient or outpatient. That’s the cost of health care. If they were truly interested in the question of why is our system so expensive, this would be a bill about how we move away from fee-for-service medicine, in which physicians and hospitals get paid for everything they do, and moving more toward value and risk, in which patients, providers are all aligned, such that everyone wants you to stay well and out of the hospital.

We would have more incentives for readmission penalties. We would have incentives for shorter stay. We would have more incentives to bring care to a less expensive place, like the ambulatory setting. But those issues aren’t being addressed in this bill.

JUDY WOODRUFF: And your point is conservatives may make that argument, but they’re not promoting…

DR. KENNETH DAVIS: If they are truly interested in changing the cost structure, making it more efficient and less expensive, they have got to deal with reforms that actually affect those metrics. And these don’t.

JUDY WOODRUFF: Dr. Ken Davis, we thank you very much.

DR. KENNETH DAVIS: Thank you.

here's an idea.

give the people the base level. everyone. you know like the senators get for LIFE...

if people want ABOVE that, then fine. they can buy it if they can afford it.

this shit is absolutely fucking mind blowing, including the corporate apologists.

if you want the fucking govt. out of everything, then just privatize the fucking military too.

>> give the people the base level. 

Define base level. Is drug rehab base level? Pregnancy? 80/20? 90/10? Perscription drug coverage? Copays? Free preventative care?

Yeah, the GOP would argue they are doing that right now, T.

'All animals are equal, but some animals are more equal than others.'

Here you go smiley - different graphics - same message! 

CALL YOUR SENATORS AND TELL THEM TO VOTE NO ON THE BETTER CARE RECONCILIATION ACT! 

ARE YOU ON THE PHONE YET? 

Call 888-865-8089 and tell your Senators that you will remember who took away health care from millions of working people. (If no one answers, leave a message.)

>>>>>>give the people the base level. everyone. you know like the senators get

>>>>>>Define base level.

>>>>>>you know like the senators get

Or as Paul Ryan would say, the people just 'choose not to buy'  the same policy that the senators get. 

Under the Affordable Care Act, members of the U.S. House of Representatives, the Senate and their office staffs who want employer coverage generally have to buy it on the health insurance exchange.

http://www.npr.org/sections/health-shots/2017/04/12/523335954/what-happe...

So "base level" is Obamacare? So Turtle's is just pushing Obamacare as the solution? 

The GOP bill exempts Congress from the provisions in Trumpcare.

>Define base level.<

MEDICARE for ALL.

how about we start with that?

>> MEDICARE for ALL.

The margins for medicare patients are negative in hospitals. If they are losing money with every patient, they would cease to exist. Right now the private payers are subsidizing medicare patients. 

Nice Chart, easy to fund by cutting defense spending and closing corporate tax loopholes (off shore accounts, etc)

all  about priorities. 

"we can't afford it"

regulate pharm prices....like other countries.

i do not understand the enders of the world point of view.

no taxes. 

no roads...

i mean like everyone still has to live mannn...mind boggling.

>> i do not understand the enders of the world point of view.

For the record, I don't support the Republican plan. 

>> easy to fund by cutting defense spending and closing corporate tax loopholes

I don't think it's "easy", we're talking about trillions of dollars. The estimates for implementing "medicare for all" are all over the place. What numbers are you using?

Every other developed country in the world somehow manages to solve this problem.

Yea, too much focus on the insurance side of the issue. The provider costs are big part of the problem. Having two prices for the same product and/or service due to the insurance is yuge problem.

kill your insurance agent.

>> Every other developed country in the world somehow manages to solve this problem.

They didn't wait until the problem constituted 1/6 of their economy.

>> Way to have a constructive conversation on one of the most important fiscal issues facing the country<<

Yes, so the GOP answer to that Thom is to have 13 old white men sit in a hermetically sealed room and secretly work on this plan. Reveal it and schedule a vote within 7 days. No public hearings or reviews, etc. Is that your version of a "constructive conversation"?

MSNBC is reporting that there will not be a vote this week

They may be incompetent in most things, but they can count.

>For the record, I don't support the Republican plan. 

for the record, neither does Rand Paul. 

Its not 'mean' enough for the libertarian crowd, including Ender.

...

fact: Rand Paul and Ender are  both just assholes.

can't see the forest for the trees. ender usually states facts that he researches. sorry it doesn't fit into your twisted view of the country.

I'm neither a republican nor a democrat. The reality is that good government should realize that they have a healthcare program in place which was a monster to get done (be it right or wrong). It would be much easier for all of them to amend what exists than "repeal and replace", etc. GOP actually has the power to have their way with the existing program (ACA).

Instead, for purely political points, they are driving Thelma and Louise style off the cliff trying to "repeal and replace". Sadly, the electorate never really understood any of this crap ("kill Obamacare, but don't take away my ACA"). So far, not putting alot of points on the board and getting more and more bad press. Just wild.

non-partisan

http://www.cnn.com/2017/06/27/opinions/fixing-americas-health-care-sachs...

Of the 22 million that would be uninsured, 15 million would be uninsured by choice:

The CBO said it and the Joint Committee on Taxation "estimate that, in 2018, 15 million more people would be uninsured under this legislation than under current law — primarily because the penalty for not having insurance would be eliminated."

http://www.politifact.com/truth-o-meter/statements/2017/jun/28/paul-ryan...

>> American spending on healthcare per person is more than twice the average in the world’s thirty-five advanced economies.

I know those are Robert Reich's words, not yours. 

But if you are comparing our spending on health care per capita to the top 35 advanced countries, you should also point out that the median earner in the US earns roughly twice as much as the average of those 35 countries. So it naturally follows we would spend twice as much. 

What else does the median American earner get swindled for?

ender def gets the nay-sayer ned award of the month.

>> According to the Kaiser Family Foundation, Medicare’s administrative costs are only about 2 percent of its operating expenses. That’s less than one-sixth the administrative costs of America’s private insurers

Many people wrongly believe that Medicare is more efficient than private insurance; that view was often stated by champions of Obamacare during the debate preceding the law's enactment. These advocates argued that Medicare's administrative costs — the money it spends on expenses other than patient care — are just 3% of total costs, compared to 15% to 20% in the case of private, employer-sponsored insurance. But these figures are highly misleading, for several reasons.

Medicare is partially administered by outside agencies

First, other government agencies help administer the Medicare program. The Internal Revenue Service collects the taxes that fund the program; the Social Security Administration helps collect some of the premiums paid by beneficiaries (which are deducted from Social Security checks); the Department of Health and Human Services helps to manage accounting, auditing, and fraud issues and pays for marketing costs, building costs, and more. Private insurers obviously don't have this kind of outside or off-budget help. Medicare's administration is also tax-exempt, whereas insurers must pay state excise taxes on the premiums they charge; the tax is counted as an administrative cost. In addition, Medicare's massive size leads to economies of scale that private insurers could also achieve, if not exceed, were they equally large.

Administrative costs are calculated using faulty arithmetic

But most important, because Medicare patients are older, they are substantially sicker than the average insured patient — driving up the denominator of such calculations significantly. For example: If two patients cost $30 each to manage, but the first requires $100 of health expenditures and the second, much sicker patient requires $1,000, the first patient's insurance will have an administrative-cost ratio of 30%, but the second's will have a ratio of only 3%. This hardly means the second patient's insurance is more efficient — administratively, the patients are identical. Instead, the more favorable figure is produced by the second patient's more severe illness.

Medicare has higher administrative costs per beneficiary

A more accurate measure of overhead would therefore be the administrative costs per patient, rather than per dollar of medical expenses. And by that measure, even with all the administrative advantages Medicare has over private coverage, the program's administrative costs are actually significantly higher than those of private insurers. In 2005, for example, Robert Book has shown that private insurers spent $453 per beneficiary on administrative costs, compared to $509 for Medicare. (Indeed, Robert has written the definitive paper on this subject, from which the above figure is taken.)

https://www.forbes.com/sites/theapothecary/2011/06/30/the-myth-of-medica...

Wait'll they privatize Infrastructure.  The UK did it with their Rail system decades ago, quite a Shitshow . . .

Privatize air

>>>>>>> Privatize air

Yeah he wants to privatize the air traffic control system.  Yup that'll work out great too.  Kinda almost glad I'm probably too fat to fly these days . . . .