Now that Republicans are in control they no longer care about the deficit, the debt ceiling, or even the price tag on an Obamacare replacement.
We are not even sure if the revisions will save any money.
Regardless, House Republicans Ready to Push Ahead on Health Plan Without a Price Tag.
House Republican leaders are set to take the politically risky gamble Wednesday of asking their colleagues to vote on a bill replacing the Affordable Care Act without official estimates of the GOP plan’s cost or coverage losses.
By moving ahead without an official “score” from the Congressional Budget Office—an estimate of how much the bill would cost and how many people might lose coverage over the next 10 years—Republican leaders are asking members to vote on a bill without independent verification that it achieves what it claims. The unknowns surrounding the bill also have served as a boon to its opponents, including some House conservatives, who are resisting moving ahead without a better understanding of its cost implication.
In a Tuesday afternoon news conference, Health and Human Services Secretary Tom Price said the bill would be adjusted after an official cost estimate from the CBO is released. Asked if the bill would raise the budget deficit, Mr. Price responded that it isn’t “the goal and the desire that I know of the individuals on the Hill.”
“We don’t know how many people would use this new tax credit, we don’t know how much it will cost, and we don’t know if this bill will make healthcare more affordable for Americans,” Utah Sen. Mike Lee, a Republican, said in a statement. “This is exactly the type of backroom dealing and rushed process that we criticized Democrats for,” Mr. Lee said.
Republicans criticized its size and excoriated Democrats for rushing the bill through Congress before all its details were known.
“Before Congress changes health care as the American people know it, we must know the likely consequences of the House Democrat legislation,” Mr. Ryan wrote in a letter to CBO at the time.
Shades of Nancy Pelosi
I guess we have to pass the bill to find out what’s in it and what it will cost.
The Goal?
We do not know what the goal is, but we know what it isn’t.
Asked if the bill would raise the budget deficit, Health and Human Services Secretary Tom Price responded that it “isn’t the goal”.
Lovely.
Earlier today I commented on Republican Debt Ceiling Shenanigans.
This Obamacare replacement fiasco is further proof the fiscal hawk conservatives of the prior eight years are nothing but a pack of hypocrites now that they are in power.
Mike “Mish” Shedlock
personally i think this is a guns vs butter decision. its interesting to see what trump wants to spend money on and where he wants to save it. if the country wants health care that’s a choice but we do need a fiscally sound budget. anyone who owns a business or lives in a condo or has a check book must appreciate it. where it gets weird is funding a wall because it provides security and then deciding to cut the coast guard budget which does the exact same thing.
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Want to see a system that would shine above the crap that we have now? Atlas MD Witchita, Ka. Start at 5:07, end at 8:22.
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Thank you for that.
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Make total sense and I think this would go over like gangbusters.
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Sorry, they took it off youtube but here’s that segment from fox news:
http://video.foxnews.com/v/5351450756001/?playlist_id=930909813001#sp=show-clips
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Sounds strangle familiar, eh?
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Since when do we believe the WSJ?
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Fake news! Raaawk! Fake news!
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Yes it is WSJ fake news and I am surprised that Mish would pay any attention to it. Paul Ryan and Newt Gingrich were on TV tonight explaining that what they have now is the first step in a multi-step process of getting everyone’s input on it and making it work for all the repubs. They need all the repubs on board with it for it to pass. No dummycrat will vote to repeal ObamaCrap.
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Man you guys are naive. Incredible.
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There is business , there is the people and them there is the professional opportunist who are called politicians. The illusion of a 2 party system is just that : an illusion.
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Usually I would agree with that Roger, but ObamaCrap is different than politics as usual. Not one repub voted for ObamaCrap when it was passed, and no dummycrat will vote to have it repealed.
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Donald Trump and his people are unaware. Paul Ryan is just a compromise technocrat.
The Federal Government needs to start enforcing anti-trust laws. They need to move directly against CEOs of health care providers. The Feds need to do the same attacking state and local structures that protect monopolistic practices.
Finally, we will never solve the high cost of health care as long as we can get someone else to pay for it. No more government subsidy. No company, union, or institution may provide health care insurance. It all has to fall on the individual.
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Don’t even get me started about Ryan. He fought the campaign all the way and then he become Mr Nice Guy? We need to get this out of the hands of state insurance commissions altogether just for starters, or nothing good will ever come of it.
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“Don’t even get me started about Ryan. He fought the campaign all the way and then he become Mr Nice Guy?”
Every election, opponents call each other the scum of the earth. The losing scum of the earth then congratulates the winning scum of the earth. Trump even changed his tune toward Hillary when the election was over. Trump was even allegedly interested in having Romney for Secretary of State.
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I’ve thought for many years that a few simple steps would solve much of the health insurance problem:
1) Have the government specify geographic regions (say congressional districts)
2) Make a law that any health insurance company can offer any insurance plan to anyone in a geographic region as long as they offer the exact same plan to everyone in that geographic region at the exact same price.
3) Have the government specify a short periodic open enrollment period in which anyone is allowed to switch from one health insurance plan to another.
The government thus solves the primary problem of people being left without an insurance pool, and the free market determines everything else.
I’m curious what others here think.
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Congressional districts? With gerrymandering? In Texas we have some districts as wide as a highway in places and 300 miles long. I can’t imagine how a healthcare plan can deliver anything consistently, much less at one price, across that geography. Your only hospital could be a 4 hour drive away; meanwhile, your neighbor across the street can use a hospital in the same neighborhood.
Nope. Just let everyone (under 65/not disabled) buy into Medicare at actuarially-adjusted rates. For 65+ or disabled it remains exactly as-is. Medicare really works, and with much more administrative efficiency, plus 1/3 of the money doesn’t go into the pockets of the insurance company CEO parasites.
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Did you actually want to understand my idea or did you just want to plug Medicare?
Healthcare and health insurance are not the same thing. I didn’t say anything about healthcare being divided geographically and I didn’t say it had to be congressional districts. I said if you offer health insurance to anyone in a geographic region you have to offer the same insurance to everyone in that region. Today many insurance companies offer the same insurance to all of a company’s employees. The only thing I am suggesting is changing the pool from a company’s employees to a geographic region.
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Healthcare is specified by insurance, not by doctors or by need. That’s reality. While shopping for insurance last November I encountered lots of plans “for my zip code” that would require me to use one and only one hospital several counties away, or else I had better be traveling and near death. Meanwhile I live 12 blocks from the best hospital for 135 miles in any direction.
And YOU specifically suggested congressional districts. Pardon me for assuming you meant what you wrote.
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Before the birth of modern medicine, hospitals were poorhouses where the indigent went to die. Then came the advent of effective medicines, especially antibiotics, along with a revolution in medical schools.
Suddenly, says economic historian Melissa Thomasson, “hospitals are marketing themselves as places to have babies.” The professor at the Miami University in Ohio says that in the early part of the 20th century, hospitals were able to focus on happy outcomes.
Health care became much more effective, and much more expensive. Clean hospitals, educated doctors and real pharmacological research cost money. People proved willing to pay for care when they were really sick, but it wasn’t yet common to go for checkups or survivable illnesses.
By the late 1920s, hospitals noticed most of their beds were going empty every night. They wanted to get people who weren’t deathly ill to start coming in.
An official at Baylor University Hospital in Dallas noticed that Americans, on average, were spending more on cosmetics than on medical care. “We spend a dollar or so at a time for cosmetics and do not notice the high cost,” he said. “The ribbon-counter clerk can pay 50 cents, 75 cents or $1 a month, yet it would take about 20 years to set aside [money for] a large hospital bill.”
The Baylor hospital started looking for a way to get regular folks in Dallas to pay for health care the same way they paid for lipstick — a tiny bit each month. Hospital officials started small, offering a deal to a group of public school teachers in Dallas. They offered a plan for the teachers to pay 50 cents each month in exchange for Baylor picking up the tab on hospital visits.
When the Great Depression hit, almost every hospital in the country saw its patient load disappear. The Baylor idea became hugely popular. It eventually got a name: Blue Cross.
“When I actually started studying this stuff, I got interested because I wondered why we have an employer-based system,” Thomasson says. “It comes right out of Blue Cross.” The genius of that approach, she says, was marketing it to groups of workers.
The Modern System Is Born
Soon, Blue Cross coverage was available in almost every state, though not many people bought in. The modern system of getting benefits through a job required another catalyst: World War II. Thomasson says that if the Great Depression inadvertently inspired the spread of employer-based health insurance, World War II accidentally spread the idea everywhere.
“The war economy is an entirely different ballgame,” Thomasson says. The government rationed goods even as factories ramped up production and needed to attract workers. Factory owners needed a way to lure employees. She explains that the owners turned to fringe benefits, offering more and more generous health plans.
The next big step in the evolution of health care was also an accident. In 1943, the Internal Revenue Service ruled that employer-based health care should be tax free. A second law, in 1954, made the tax advantages even more attractive.
Thomasson cites the huge impact of those measures on plan participation. “You start from 9 percent of the population in 1940 to 63 percent in 1953,” she says. “Everybody starts getting in on it. It just grows by gangbusters. By the 1960s, 70 percent [of the population] is covered by some kind of private, voluntary health insurance plan.”
Thus employer-based insurance, which started with Blue Cross selling coverage to Texas teachers and spread because of government price controls and tax breaks, became our system. By the mid-1960s, Thomasson says, Americans started to see that system — in which people with good jobs get health care through work and almost everyone else looks to government — as if it were the natural order of things.
But to Thomasson and other economic historians, there’s nothing natural or inevitable about it. Instead, they see it as the profound result of historical accidents.
http://www.npr.org/templates/story/story.php?storyId=114045132
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Thanks! Great read.
It’s probably true that in an economy, and demography, like the one of the first two to three decades post war, things like “lifetime employment”, “defined benefit pensions” and “employer provided health insurance”, “union shops” etc. can give the temporary illusion of actually working.
Especially since the deck had been largely tossed by the depression and the war, so that there weren’t that much of a well connected leeching class left. And, the financialization rackets were still somewhat .limited due to the, at least nominal, peg to Gold.
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Here’s the reaction about this from the true believers in the nth “change you can believe in” candidate and party. Oh, ye, of far too much faith…
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Obamacare is itself just RomneyCare Light. So now we come full circle back to RyanCare. It’s ridiculous and won’t make anything more “affordable”.
All I can say is take good care of your own health because you cannot afford to get sick unless you are quite wealthy.
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Worse than that, the whole idea was cooked up at the Heritage Foundation as a response to Clinton’s 1993 attempt to overhaul healthcare.
I love the irony that a plan devised by a conservative think tank was pushed through by a Democratic president, who’s actual policies were to the right of Richard Nixon, while being called a socialist.
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The epitome of cognitive dissonance.
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Trump, who splashes his name on everything from buildings to steaks, doesn’t want his name anywhere near this bill
http://www.politico.com/story/2017/03/trump-branding-obamacare-repeal-235831
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Paul Ryan is a coward, and Trump is just “letting” Ryan commit career suicide. Having said that, Trump needs to stop playing with the infants and get on with what he promised voters. Ryan will cook his own goose whether Trump helps or not — why is Trump foolish enough to get distracted?
If Ryan or Pelosi or any other crook really believed in govt health insurance, they would lead by example. They would be on the same program they try to force on the people they work for.
RYAN IS A LOSER AND A COWARD — JUST LIKE PELOSI.
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As much I would like to believe Ryan is ending his political career, I think it’s highly unlikely. His district is highly Gerrymandered and his family controls a significant portion of the economy in his district. Plus, no one wants his job as speaker – too many cats to herd and a president that wouldn’t even begin to pass the Republican political purity test. He may be “demoted” to minority leader, but he’ll be in congress for a very long time.
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The purpose of insurance is to provide some financial relief for unexpected calamities like car accidents or heart attacks – things that rational people would prefer not to have, with or without the ensuing financial damage.
Because such calamities are usually preventable to some extent, insurance policies normally carry a deductible – partly to discourage fraud but also to discourage the kind of behavior that made the calamity more likely. In the case of driving, a deductible becomes a penalty for not being as careful as one could. A deductible in health insurance is – or should be – the penalty for not taking better care of one’s health. One can make heart attacks and other health calamities less likely through diet, exercise, nutrition, learning about and monitoring health, and by considering one’s family history, etc. But, with any kind of insurance claim, you only pay the penalty if the calamity occurs. The higher the deductible, the lower the premiums should be.
Government health ‘insurance’ programs are not really insurance as they are designed to provide people with money for anything they go to a licensed doctor, pharmacist, or testing facility for. All this does is drive up the costs by enabling health care providers of whatever kind to continually raise prices and salaries.
It’s time to go back to square one starting with the education of people as to what insurance really for. And then let each person figure out what kind of insurance would suit him and his family best – maybe none.
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Yes, health insurance has become a moral hazard. Heads I win; tails you lose.
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Health insurance is income redistribution and the ONLY reason ANYONE buys it is in the belief that SOMEONE ELSE will pay for it. This is why it is imperative for the actuarial technocrats insist on FORCING everyone to participate, for like all other socialist schemes, you eventually run out of other people’s money…..and in that epiphany moment of realization, they will reach out for EVERYONE’S pocket.
The notion of insurance as a self funding “emergency fund” is flawed as we see that in almost every instance we see costs spiral out of control. You cannot have the end user separated from the provider. I paid my over priced premiums and DEMAND only the absolute BEST…..and the costs zoom to the moon.
Insurance is a fallacy that is perpetrated by those who profit from it.period. We want to believe…that no matter the cost, we can get a better deal. We get phone calls every day from people PROMISING us a better deal on something…on everything, and we so desperately want to believe…
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In need an explanation. Why can we not simply repeal the ACA?
Is it because we MUST provide affordable insurance for preexisting conditions?
Is it because we MUST provide affordable insurance to the poor?
Is it because we MUST provide parents the ability to ensure their children until they can qualify for Medicare?
When did these MUSTS become MANDATORY?
Just curious because these did NOT seem mandatory until about eight years ago. While insurance was expensive, most of us seemed to be getting by.
It seems like the world has been turned into something else in the last ten years, and while I understand it is the progressive agenda, I DON’T understand why the majority of people stand for it.
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When did these MUSTS become MANDATORY?
When the narrative started being strewn out years ago the health care was a right. The sheeple listen to the rhetoric long enough that they believed it (Joseph Goebbels). Soon after, all hospitals were directed to treat everybody, and when a good size portion on them didn’t pay, the distributed the losses to larger bill that insurance companies passed on to their subscribers,,, and on and on till we found ourselves wading in horse shit so deep we could no longer function. We could sort this all out real quick… Outlaw health insurance and watch the medical community start bitchin’. it would be worth the show. if you can get us to that point, then I will volunteer to make the popcorn.
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…and there will be real butter on it.
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What can’t continue, won’t. Ignoring the inevitable healthcare and economic reset is like believing in iternal life with no taxes. Yet, the obvious is continouesly debated, while an ax murderer lives under our roof.
The healthcare industrial complex spends more on lobbying and donations than any other industry, which is why you will never see anti-trust laws addressed or tort reform. What is also troubling is why Mish ignores these issues. I suppose it’s the same reason he blames the Fed and the lack of a gold standard for all the problems. The root problem is govt, or more specifically, the career politician.
Confronting the truth can be unconfortable or liberating. Of course the Republicans and Democratic establishment are hypocrits. Discussing what type of hypocritical fraudster they are does nothing to advance the ball.
The political world is obviously melting down, which means the socialist system that many have come to rely on is also melting down. Socialism is predictably failing society, and is the root of the anti-establishment movements. The only questions that remain are how do we survive the reset and what system rises from the chaos.
I strongly encourage readers to resist the totalitarian lifeboats that will be launched by the establishment that only seeks to save themselves. Our Founders new history much better than most today, and they understood that freedom is the most essential ingredient of prosperity. Since govt is antithetical to freedom, govt must be limited.
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Why would Trump tolerate this nonsense? This GOP proposal is fake health care. Just a different colored lipstick on the pig. More money for the health insurance companies. There is a huge amount of pushback on the proposal from across the board. The GOP is going to pay dearly in 2018 if we get served a shit sandwich for a second time.
The Commonwealth Fund study shows that we spend twice what the average 1st world nation spends in per capita health care costs and our health care quality is one of the worst.
Why are other nations able to spend HALF of what we do and give their citizens BETTER health care than we get in America?
THAT’S THE QUESTION THAT NEEDS TO BE ADDRESSED!!!!
It’s outright FRAUD and CORRUPTION!!!
The health insurance industry bribes the politicians then the politicians give them the pen to write up the health care legislation that the politcians rubber stamp!!!
IT’S TIME OUR POLITICIANS STARTED REPRESENTING THE PEOPLE INSTEAD OF THE HEALTH CARE CORPORATIONS!!!!
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I think Trump is giving Ryan the rope to hang himself. Trump has gotten the House and Senate to begin the process of repealing the ACA. Just a few weeks ago everyone was still sitting on their hands. I think Sen. Paul is Trumps back channel player. There will be two bills in the House – Obama Lite and the FC full repeal. Now the fight is on as to who can deliver the most votes for their bill. The Senate can work on their own bill at the same time. The two bills will then need to go to committee to fix the differences. Trump has to play the two sides against each other and not disclose his hand. Remember he has to work with these idiots on other issues, so he can’t be seen as favoring one group over another.
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I’m wondering if trump is going to use twitter to urge the voters to call their Congressional Representative? They’d shut down Washington’s communications all jamming the lines in.
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You have to be thick as a brick to believe Trump has any kind of strategy whatsoever. Stupid people don’t know they’re stupid, and apparently can’t recognize stupidity in others, either. Trump is a moron, and you’ve been had by a moron. Whatever you need to do to come to terms with that, you better start it.
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How can Trump say that he’s putting America First if he allows illegal foreigners to enroll in free healthcare programs like Medicaid which are funded by the US taxpayers when many working class US citizens struggle to pay their premiums and are faced with deductibles of $7000 or more?
In California illegals 19 years old and younger are entitled to enroll in Medicaid. WTF?
All the old rules that made sense are being dismantled.
What good is it having citizenship anymore?
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I think they should concentrate first on making health care more affordable, as that is the first step in making health insurance affordable for both the fisc and the people. The first step should be a gold standard, to help tame outrageous health care inflation. The bank is printing out of control service sector inflation.
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Meet your new boss…same as the old boss. “Hypocrites” doesn’t even begin to capture the essence of our modern day politicians. Lying is now standard practice in the service to money and power. Representative government is an afterthought, something reserved for the 15 second soundbite on the evening news.
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The Citizens United ruling was the de facto coup d’etat of the USA. The government officially works for corporate money now. And most people don’t even care.
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So a secondary thief, corporate America, is stealing from the primary thief, government.
So stealing is okay if the right group does it?
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The genie is out of the bottle and will never be put back. Our representatives will do as they like. ACA will never be repealed as those that get the tax payer funded programs would riot. They basically have it all now so why work. The AMA and medical community have their permanent taxpayer welfare.
Personally it should be repealed but will never happen. Single payer in the future is coming. The only way to get medical cost under control at this point is to nationalize medical care. As more and more people continue to lose most of their disposable income they may finally want it tossed out.
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Cost is because of two factors. Demographics work against us, too many old people. The other is free healthcare to those unable to pay. Either cut back our healthcare layouts or pay the increased cost. That is the reality.
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Healthcare is not a market in the USA. Markets require transparent pricing. Without transparent pricing, there can be no competition. Prices can then become unrelated to actual costs. That’s the problem.
But no one on the right wants to recognize that because it doesn’t fit with their beliefs about the economy. And being a majority conservative country, it can therefore never be fixed.
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Why do we continue to call this, and ObamaCare, health care bills? It’s not about health care, it’s about health insurance. Insurance and health care are NOT the same things. Not even close.
It’s time we make health care affordable, and then insurance costs will come down organically.
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The problem isn’t insurance, the problem is the cost of health care.
Government mandates have driven up cost, just as government intervention drove up the cost of housing and education.
No one in either party seems to be talking about USC 15. The medical industry seems to be exempt from it. The question is- why? What is deemed special about the medical industry?
Denninger for one, harps on about how prices will drop as much as 80% from enforcing the law. That the cost of medicare would drop dramatically, which is a huge portion of the federal budget.
I don’t know how close Denninger’s numbers are to being correct, but the medical system is spiraling out of control. Health insurance shouldn’t cost as much as a mortgage payment.
Nor should a college education.
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I’m old enough to remember people believing health care costs were spiraling out of control in the 1970s. It has just gotten a lot worse. And it will continue and be a lot worse 30 years from now.
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Denninger goes on and on about getting sodomized too. The guy is mentally disturbed, why do you talk about him like he’s anything but a loony internet crank? He belongs on 4chan or some other internet sewer.
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