Trump is giddy as are many Republicans over a bill to repeal and replace Obamacare that took place moments ago in the House.
Before anyone gets too excited, the bill may be dead on arrival in the Senate.
Either way, the consequences are not pretty.
Reuters reports U.S. House Passes Healthcare Bill in Big Win for Trump
“The Republican bill, known formally as the American Health Care Act, aims to repeal most Obamacare taxes, including a penalty for not buying health insurance. It would slash funding for Medicaid, the program that provides insurance for the poor, and roll back much of Medicaid’s expansion.”
Dead in the Senate?
Next consider In Senate, Pessimism Over ObamaCare Repeal
A senior GOP senator said the chances of getting 51 votes for legislation based on the House healthcare bill are less than 1 in 5. The senator also put the chances that the House bill will meet Senate budgetary rules preventing a filibuster at less than 1 in 5, meaning portions of the legislation would have to be removed.
Republican senators say the House bill will have to undergo substantial revisions and they have serious doubts about whether the House will accept those changes.
Prematurely Cheering
A pair of tweets by Caroline Baum explain how I feel as well.
Trumpcare
Let’s assume that months from now (and that’s about how long it will take) some sort of compromise bill passes the Senate. Let’s also assume the House votes to go along.
Then there will be winners and losers, but far more losers than winners. The losers will be upset. Even those unaffected may be upset if they blame the bill for increasing their costs.
For What?
This folly could cost the Republicans their majority in the 2018 midterm election.
For what? The bill nibbles around the edges and provides no incentives to lower costs.
This is a disaster on-deck with virtually no chance of an upside. Republicans now own healthcare (Trumpcare) whether a compromise bill passes or not.
Hooray?
Mike “Mish” Shedlock
Simply enforce the laws against monopolistic practices, fraud, deceptive practices, anti competition practices, and RICO. Healthcare is an organized criminal racket. Oh, that’s right, it gives freely to any politican who asks for money. what was I thinking?
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Amen. Hear. Hear. The elephant in the room. That goes unrecognized.
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We don’t believe in government regulation here.
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Funny thing is, the states have similar laws on the books and don’t enforce them against healthcare providers. Simply amazing.
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Then get rid of it. All of it. Every law, rule, ban and regulation, along with every tax and mandate, and every single government employed hack required to keep the whole theft racket charade afloat. And then, watch things sort themselves out just fine. Or at least much finer than this idiocy.
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What NOVEL IDEA! Get the Government out of healthcare, and the patients will recover,ASAP. We already have two forms of single payer healthcare , The VA and Burgheau of Indian affairs. The Democrats want single payer so they can manage and push us around just like these two loser outfits.
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Also, you can never resolve the high cost of healthcare as long as you can get someone else to pay for it.
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Well, what’s a trillion or two added to the federal deficit? I mean, it’s not like us peons have any money to pay for it.
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What exactly do you think health insurance IS? It is ABSOLUTELY about someone else paying your doctor bills. If you were paying your own, what the hell would you need insurance for?
We are in a trap. We want the latest greatest bestest healthcare on the planet (and beyond if possible) and we don’t want its cost to cut into our entertainment budget, and we sure as hell don’t want to go broke to simply survive a life threatening illness….how “fair” would that be (completely ignoring a timeless tradition of fairness NEVER entering into any equation of life on this planet)
But no. We have an all powerful government chocked full of geniuses who can wave their magic money wand over their microphoned podium and simply CREATE fairness in the world by simply making someone else pay for it…..especially someone not yet born that will find themselves indebted to some completely insane amount…..to pay for our fairness pipe dream.
Republicans were screwed the moment ACA was passed. healthcare is now a RIGHT. Preexisting conditions are now covered…it’s only fair, right? None of these squishy moderates would EVER take that away from us….they’re not ANIMALS.
Nope. we’re just screwed. Our sweet empathetic minds simply refuse to deny anyone of anything (it just wouldn’t be fair) and thereby guaranteeing that medical costs will only go to the moon. There is not a single rational person on the planet who can prove that there is ANY mechanism to create efficient pricing beyond competition…..the one thing our collectivist, socialist, communist empathetic spirit just will not tolerate.
Sure, we could provide for preexisting conditions more affordably if we simply allowed some competition, but that is verboten now, so the only path is compulsory single payer. When the ship is sinking, the only thing that apparently makes sense is to bring more people into the boat to help bail, but strangely enough, hope floats and many if not most of those theoretical “bailers” are only interested in keeping their feet dry.
Watch the republicans hands. They are getting rid of the ACA “costs” to consumers, and rolling into the taxpayer account. Everybody KNOWS that it is always someone else who pays most of the taxes….the RICH, right? Not you or me. Saved again!
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The US spends more per capita on healthcare than an other nation. Most western nations have some type of universal healthcare or single-payer system. Does that change your view at all? https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
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The point is if the senate stops it, we just have to throw out the senators
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Senate will wilt and pass SOMETHING … then it will go to Conference with House … and something even worse (for the taxpayer) will emerge.
Hooray!
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No.
In reconciliation obamacare can be repealed.
Just like the way it was passed.
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You have a future in doing Stand Up.
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Let’s hopr
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“On my first day in office, my first year official act as your president will be to repeal Congressional exemption from Obamacare. Once all of the Senate and House become subject to the terms of the ACA , we’ll be on our way to repeal of it.”
~ Sen. Ted Cruz (R-TX) candidate for president during the 2016 campaign
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For What?
This folly could cost the Republicans their majority in the 2018 midterm election.
For what? The bill nibbles around the edges and provides no incentives to lower costs.
This is a disaster on-deck with virtually no chance of an upside. Republicans now own healthcare (Trumpcare) whether a compromise bill passes or not.
…
Durn you
What am I supposed to add??
I will add this – Leadership rushed this out – purposely – before CBO had a chance to score it. As CBO will show this bill will add $hundred of billions ($trillions) to the deficit / debt over the coming years. CBO supposedly will have its score next week (could Leadership make them sit on it till after House and Senate agree on a bill?). Hopefully, Senate will delay / debate bill until the score comes out.
Disgusting job by the Republicans.
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Deficits only count when there is Democrat in the white house.
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Obamacare was funded with a 3% income tax surcharge on very high-income folks. That surcharge goes away. That’s what this has always been about.
I’ve given up caring about other Americans. I’ve got mine. Great insurance paid through work. All prescriptions are free. I will retire in a few years and can and will live on much, much lower income. I’ll put a bunch in an HSA and let it roll-over so I’ll have cash on hand in retirement. And I’ll use the tax credits for as much as possible. May look at setting up a pass-through llc to fund some activities so I don’t have to show everything as income.
But, yes, the Republicans now own it. Insurance companies will be in chaos waiting for the Senate to make a decision. It will be fun watching what happens when people start seeing what they voted for. Screw ’em.
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Obamacare was funded with 300 billion annually from Fannie May and Freddie Mac. I think in government-speak its called an ‘asset sweep’. Others may call it theft …
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So higher taxes = caring about other Americans
You just can’t fix stupid.
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Why does higher taxes = caring about other Americans?
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I thought there was just one American, but now there are ‘other ones’. Are there some you don’t like to talk about ? Politicians ? This is getting confusing.
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Like everything government does it was about stealing from somebody and giving to someone else.
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…..And taking a nice cut for doing the deed.
But hey, that’s what America in the Progressive era is all (as in literally all) about: Childish excuses for why “Thou shalt not steal” somehow doesn’t apply anymore, since “theeengzz are diiiierent theeez tiiiime.”
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Will this mark beginning of the end of Paul Ryan’s leadership? Will Trump realize he needs a complete restaffing to get anything done?
Stay tuned ….
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It will not be “fixed”, nor will a solution be found until the American people demand that any bill passed applies to Congress, their staffs and all federal workers. Only after this is done will a balanced and affordable solution be reached.
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The republicans actually did this:
https://mcsally.house.gov/media-center/press-releases/house-unanimously-passes-mcsally-bill-striking-ahca-exemptions-members
No ask yourself. Why didn’t the democrats do this when they passed obamacare?
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LOL. Because its idiocy. Folks who already have insurance don’t have to deal with the ACA or AHCA. Congress already had insurance and fedgov already met the requirements of the ACA. So there never was a need. Pure political stunt. But apparently effective.
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Apparently having Congress live under the same laws and regulations as the rest the citizens in America is a big joke to you.
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Won’t know if it’s effective until the mid terms.
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“It will not be “fixed”, nor will a solution be found until the American people demand that any bill passed applies to Congress, their staffs and all federal workers.”
The federal government’s healthcare system is self-funded with insurance companies used to manage network and billing. If that was spread to the population it would look very much like Canada’s single-payer system. Except the Canadian government does manage pricing to ensure prices are reasonable.
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how do we move from a system that costs 18% of GDP with low quality to one that costs 5% of GDP with highest quality on earth ?
In 1965, health care cost 5% of GDP and was best on earth
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In 1965 what percentage of healthcare costs were paid by insurance?
If you were told that you could pay into a fund that guaranteed you a new car every two years, would you take the Ford Focus, or demand the Mercedes SLS roadster?
We pay our premiums and demand the best, yet are shocked that our premiums increase every year and demand even more superior care in revege. As those costs increase ever higher, fewer and fewer can afford them. As healthcare is a right (and has been for decades now given no one can be refused hospital care), those who find the expense screwing with their priorities can simply opt out and take their chances with the hospital. But with ACA and pretty much anything the Republicans can come up with, that healthcare is pretty much guaranteed, preexisting or not. Like anyone with a spending “problem” our solution is found in default. But in a world were every person and thing is leveraged to the max and our only “real” store of rising wealth is the stock market, default can no longer be an alternative, because now it is not simply a failure but a contagion that threatens ALL entities on the planet.
It is a hell of a thing. We have connected everything together in a grand survival raft that each and every person is clamoring aboard, pretending it is a pleasure ride when they know why we are here and where we are heading.
Congress, as well as all other progressive denialists,will continue to pretend that all of these social and economic injustices can be remedied by simple declarations with NO productive actions to sustain them. Our debt will continue to climb higher while we’ll play ignorant as to why. We will blame big government spending while continuing to suckle at every free tit we see. Our corruption is nearly complete and appears irreversible. There will be no collapse, no reset, no reaffirmation of conservative principles that created our prosperity. They will have full control and we will be fully dependent upon it. And best of all, They won’t even need to defend it, as we, the dependent, will dispose ourselves of any threat to its continuance. Like those black masked leftist protestors, we will simply intimidate and silence the voices that would reveal the truths we already know to exist.
The threat of thought.
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Calling the Rs the stupid party is far too complimentary.
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Calling the D’s intelligent is far too contradictory.
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With the Democraps chanting “Na na na na, Hey Hey Hey! Good By!” to the Rethuglicans, once again, our politicians show their class. Trump has increased my productivity and quality of life. How? I stopped watching TV and spend more time at my job and self improvement. Government will never help anyone like me.
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That was such a childish and juvenile display of hubris by the Democrats. Unbelievable. They really could not give a ‘F’ about America.
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I really don’t mind if Trump & the Republicans put the name of their party (and their names) on a bill that they knew the Senate would reject big time and bail them out in the face of their constituencies. The key here is to hold them accountable in history for their actions when elections come around. I am big on ethics in government & business. Good demonstration of the collective consciousness of congress & a broken government.
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So here’s the deal. Smart, healthy, hard-working Americans already have health care through their employers. The elderly have Medicare. The poor have Medicaid. Veterans have Tricare. Who does that leave?
Sick people who have some income and can’t qualify for any of the other stuff. Lower income working class folks with poorly paying or part-time jobs. Young folks just starting out who haven’t hit their stride yet. These people are all lumped together because everyone else has insurance. Why don’t these folks have insurance naturally? Because they don’t make enough money or because they are guaranteed losses due to pre-existing conditions.
Obamacare basically tried to get these people insurance through a range of regulations, especially on pre-existing conditions, forcing young people to join or pay a fine, and providing community rating subsidies to insurance companies that take on higher risk.
The Republican plan blows this up. These folks can’t afford to pay up front for insurance and wait for a tax credit in the end. Without community rating, prices will collapse for the young, but for older folks it will blow through the roof.
Trump just gave a windfall to young democrats and put a bullet in the back of middle-aged Republicans. All to give a few rich folks a nice tax cut. LOL.
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ACA had very high deductibles. Lots of people have insurance they can’t afford to use no matter ow cheap it is…even if it is free.
People used to be cared for by charity, by church run hospitals decades back. Americans were generous people for the most part.
Today charity is compulsory but we are told that America is FINALLY living up to its promise. So this compulsory generosity is supposed to say something about us? All it tells me is that we are big fat liars who want to pretend we are something we are not and are not above using FORCE for some of us to feel good about ourselves.
We see countless billionaires and millionaires lecturing us about how we should be more generous, willingly raise our taxes, YET, they pay top dollar for tax avoidance, they set up foundations to simulate charity while using them for tax avoidance and to pay their family and friends. These people could easily spend half their wealth helping other people that they claim to care so much about, but instead use their money to induce politicians to come after US.
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Now, when it eventually fails, as it will, and since no Dems voted for it, the failure will be pinned on the Reps in 2018. Brilliant.
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Exactly.
The Judge and Jury for households will be their premiums going forward.
When they continue to ratchet upwards they’ll know who to blame.
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As revealed by this as well as the budget just allowed to pass, the Reps have now fully exposed themselves as the fake/controlled opposition. They are just as much fans/tools of “the swamp” as the Dems.
They like it better when they are the minority. They then have a built-in excuse for not getting anything done. They can fund raise like mad over their claim of the need to defeat democrats then, once in power, act almost exactly like them.
A spot-on post I found elsewhere:
Republicans:
2010 – “Give us the house and we’ll change things”
2012 – “Well, we need the house and the Senate majority to get our agenda through”
2014 – “Actually, we need the House and the Senate and the Presidency to really get things done”
2017 – “OK, we really really need all those things and a super-majority in the Senate to do this”
2018 – “At least we funded the border”
2019 – “Give us the house and we’ll change things”
My voting will from this point forward be limited to local and state issues.
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Rep. Paul Ryan (R-Wi) : in the tank for the insurance lobby.
Sen. Rand Paul (R-KY) : in the tank for the medical establishment.
These guys know who they work for and it ain’t the citizens. I will give Trump credit for at least trying.
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Dr Rand Paul
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House Democrats chanted, “Na na na na, na na na na, hey hey hey, goodbye!” after floor vote was counted for the passage of the American Health Care Act (AHCA). What’s that tell you?
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That the Democrats are juvenile and not very bright.
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They’re idiots but are all mostly from safe districts where they represent even bigger idiots.
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Why don’t Americans look at the very successful health care systems in so many other countries? Why do you continue to pay twice as much for a system that doesn’t cover everyone, and results in such suffering and lower life expectancies? Trumpcare will end up covering fewer people than Obamacare and cost more. You’re going in the wrong direction!
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You can always count on Americans to do the right thing, after they’ve tried everything else first.
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Not really or one has to wait for 100+ years
Example: Beginning in 1950, American military advisors arrived in what was then French Indochina.U.S. involvement escalated in the early 1960s, with troop levels tripling in 1961 and again in 1962.[60] U.S. involvement escalated further following the 1964 Gulf of Tonkin incident, in which a U.S. destroyer clashed with North Vietnamese fast attack craft, which was followed by the Gulf of Tonkin Resolution, which gave the U.S. president authorization to increase U.S. military presence. Regular U.S. combat units were deployed beginning in 1965. Operations crossed international borders: bordering areas of Laos and Cambodia were heavily bombed by U.S. forces as American involvement in the war peaked in 1968, the same year that the communist side launched the Tet Offensive. The Tet Offensive failed in its goal of overthrowing the South Vietnamese government, but became the turning point in the war, as it persuaded a large segment of the U.S. population that its government’s claims of progress toward winning the war were illusory despite many years of massive U.S. military aid to South Vietnam.
Gradual withdrawal of U.S. ground forces began as part of “Vietnamization”, which aimed to end American involvement in the war while transferring the task of fighting the communists to the South Vietnamese themselves. Despite the Paris Peace Accord, which was signed by all parties in January 1973, the fighting continued. In the U.S. and the Western world, a large anti-Vietnam War movement developed as part of a larger counterculture. The war changed the dynamics between the Eastern and Western Blocs, and altered North–South relations.[61]
Direct U.S. military involvement ended on 15 August 1973.
So based on that recent history between 2050 and 2073 the light bulb will hit the US????
LOL
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“Why don’t Americans look at the very successful health care systems in so many other countries?”
Because the moneyed special interests who own our government don’t want that. Simple as that.
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“Why don’t Americans look at the very successful health care systems in so many other countries?”
===========
Because there are a huge number of stakeholders in the healthcare industry that are not inclined to see their cash cows strangled. Our Congress is dependent on campaign contributions from these stakeholders to stay elected. So until the money is taken out of politics, it is unlikely that there will be any major change to healthcare here. Same for tax reform.
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Trump was huuugely outspent by Mrs. Clinton and still won the election. Money does matter, but not to the extent most will claim.
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My comment did not really pertain to Trumpo. It was meant for Congress, where amount of $$$ usually does affect outcome.
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corruption
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MEDICARE for everybody
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We ALL want healthcare insurance.
Where is it declared that it is a right?
I want a PENTHOUSE in Manhattan.
Where is it declared that I should have that as a right?
No where has anyone suggested a minimum standard of “humane care”. I would be willing to support compassionate and humane care. I am not willing to contribute to extended and expensive care across the board. It is not a “right” to live in a Manhattan Penthouse and I do not expect Trump to give me his. Quite honestly, I object to “free lunches” which now seem to be a “right” in schools.
We have simply lost sight that there is “no such thing as a free lunch”.
When I go to a store or restaurant, I look at the prices and make a choice.
Limited healthcare and limited housing and limited food. If you pay for it, then you get to choose. If not, take the minimum level that is agreed upon.
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I would not live in a Manhattan penthouse if it was free for me, but everyone’s tastes are different. All I want is for the government to leave me alone.
The first problem in trying to “fix” the ObummerCare disaster is that once you give people something, it is almost impossible to take it away again.
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If you don’t want government services, then suggest you move somewhere where there is no government. Say Somalia?
Most of the rest of us DO want a functioning government and the services it provides.
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You seem to misunderstand, Joe. I am not an anarchist. I do want a government that provides basic services, like defense (not offense), courts that rule according to the law and protect property rights, and the gov has not done a really bad job so far of building highways, etc. (Thank you, Ike). But I live in CA and the government here is totally out of control. I love CA but I might have to move because of the horrible state government.
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Here is my question. Why is it that every other First World nation spends so much less on health care than the US and yet get better results like lower infant mortality, longer life expectancy etc? What do they do that we don’t do? Why do we spend so much and get so little? Are we stupider than everyone else? Do we have more money to waste?
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I’m not sure why America’s system is so inferior to dozens of others, but I think it has something to do with American pride. They refuse to believe that another country can be better at something. When I travel throughout the world, I often run into Americans, and one of their first questions is often about the health care system in the country I live in. When I try to explain it, they often shake their heads and refuse to believe that it could be so good.
I think that the American political system has bamboozled the average voter into believing the other systems are all horrible. That’s how communist countries used to lie to their citizens as well; saying how good it was in the communist country and how awful it was everywhere else.
I guess you can fool most of the people, most of the time.
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I am soooo tired of hearing the propaganda, “America’s system is so inferior to dozens of others…” It is not inferior. You cannot extrapolate the needs of a diverse population of 330 million and the delivery of care to same, to a MUCH smaller country that is more homogenous. To where do the rich flock when they get into trouble? Where do you want to get a blood transfusion? An organ transplant? Do you really think that the USA system is so bad that the smart money goes there to be wasted?
In the USA, the food is less expensive, and there is more freedom of choice of self abuse as a result. So millions abuse themselves with food, booze, drugs, sexually transmitted viruses, etc… Where are the most medical and pharmaceutical innovations coming from that get adopted world-wide? The freaking USA helps to fund the medical progress of these other nations!
Also, who is compiling these stats? Who? WHO. Answer that. An immigrant baby dies in the USA because the parents just came over the border with crap for prenatal care and guess what? That goes on the child mortality stats for the US. NOT Mexico, etc… Immigrants flock to the US for dialysis – like crazy.
I invite Realist and all others with that same mindset to avail themselves of the medical systems offered elsewhere. I am happy with what is offered here.
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Thanks Mox. I do indeed live in another country (thank goodness) and I do enjoy a wonderful health care system. I see my doctor as often as I want. I have had several operations, and received wonderful care. I don’t have to pay any premiums, deductibles, co-pays, etc. All I pay are my taxes. You are welcome to keep your broken system that you are so happy with. Would it hurt you to investigate what other countries do?
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What is your country’s population? Immigrant burden? Tax burdens? Cultural philosophy about providing dialysis services to those over 75 yrs old? Is the US providing military assistance to defend your country? Are you a net asset to your country? Are your cancer services cutting edge?
The issues are multifactorial, and once again, you cannot reasonably compare a small country to a large one. Soooooo,
Where are you from, Realist? Really.
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Having lived in many different countries and under different health systems, I can see aspects that I agree with in both sides of each argument.
Universal healthcare on offer by the state is a very recent phenomenon, historically speaking. It is too early to say whether this experiment will be sustainable for any length of time – especially for the many ageing national populations. So enjoy your universal healthcare wherever you are while you can. My personal opinion is that is cannot last. Anywhere. Eventually you run out of other people’s money.
The question is whether or not the American people can accept a healthcare system that is rationed. I do not think that they can, nor do I think that the medical community is ready. It takes a certain mind set for medical professionals within, and the customers of, a rationed system. Americans are not attuned to this yet, in my optinion.
My opinion is that we are already living in a post-universal health care world whether we like it or not. America may be the first major nation to find its way through this new and challenging environment.
In any case, America needs some very smart people to work this out – the best and brightest from around the world. Not a bunch of politicians jumping from one ideology to the other.
And such a program micro-managed at the federal level is doomed to failure. Most of it should be handled at the local level, with local decisions for the local community. That is the only way to build a robust healthcare system that works.
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@Mox Nix
Everything you said in your post is factually wrong. The EU has a larger and more diverse population than the US and provides better health services to its population at a lower cost (and better outcomes). The food tends to be cheaper and lets not talk about access to drugs, booze and sex. Just in case you don’t know all the members countries offer a single payer type of insurance (with variations among members). One more thing, even private insurance is less expensive than in the US and the reason (IMO) is that with the universal access that the government (that most of you seem to hate) the private sector has no choice but compete. Finally, it seems most Americans has huge issue with government expending billions providing health care to its citizens to preserve lives and no one seems to mind expending trillions in a defense industry interested in killing. That tells me how mentally ill this country is.
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Why is health care more expensive in the US? Here are a few reasons:
1.) We allow hospitals to force us to consent to service without a price, and not just when we’re unconscious at the emergency room. Then, they charge us prices based on what they’ve negotiated with the insurance companies. Despite what you would expect, the insurance companies don’t care if the price goes up, as long as they can collect the premiums. If you don’t have insurance, the price is 3-5 times more than what they would charge the insurance company, although they mostly just do this in order to get the tax write-off and to convert charity donations into profit.
2.) We forbid re-importation of drugs, and we support anti-competitive patent behavior that allows renewal of patents based on immaterial changes. So drugs that sell for $100 in other countries sell for $100,000 here in some cases (e.g. anti-venom). Most cases aren’t that extreme, but in other countries they pay a lot less for the same patented medicines.
3.) We limit access to medical school, artificially lowering the supply of doctors all while raising the entry cost to become a physician. This means that medical residents have to work 80+ hour weeks and are exhausted (leading to worse medical outcomes), all while being chained to $250,000 in student loans. If we would allow more medical schools to open, there would be more doctors who could work less hours and afford it due to carrying less debt. Of course, overall, doctors incomes would drop a bit, but a lot of the money actually goes to administrators, drug companies, and other rent-seekers.
4.) In some cases we limit the formation of new medical services, so that, for example, if you want to open a clinic with an MRI machine you have to get a certificate of need. This is inherently collusive and anti-competitive, and that’s why an MRI costs thousands of dollars instead of hundreds.
5.) At hospitals, many physicians are actually separate contractors not paid by the hospital. So you can be in the hospital for 2-3 days, and then you get a bill from every doctor who wandered into the room, even if just for 15 minutes. Each doctor bills you once for the full price for the same service, because they are individual business entities. So instead of one bill for $600, you get three bills for the same amount, despite not having received three services. Hospitals could mediate this situation, but as long as the money flows, why bother?
6.) Due to decades of health care “reform” that has resulted in health care in the US constituting 19% of GDP or so, politicians are now boxed in and unable/unwilling to take any action that would reduce the health care sector down to the 8% we see in other developed countries, since doing so would force a 10% reduction in GDP, which would get them voted out of office or maybe even lynched.
7.) Voters believe in fairy tales such as “health care is a right” or “America has the best health care system in the world”. They fight about whether we should move to a single-payer system or return to a free market system, and there is no agreement on the right reform. Even though the Justice Dept. could compel a substantial correction to the system using existing anti-trust law right now, they will never do so because of point (6).
I could go on, but I would bet that you already knew most of this. And yet still nothing changes.
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The fundamental reality is that representative democracy isn’t working. We need more fine-grained democratic controls over legislation. Until we have that, politicians can use bait-and-switch tactics to remain in power based on meaningless social and cultural issues.
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“The fundamental reality is that representative democracy isn’t working.”
Sure it is. Since the founders stupidly failed to specify that “persons” in the Constitution referred to natural persons and not artificial persons like corporations, the SCOTUS has ruled that corporations have 1st Amendment rights and that MONEY is “free speech.”
Thus, a million dollars of “free speech” from a special interest group which gets the candidate elected because you voted for him ensures that the candidate you voted for has more allegiance to the wishes of that donor than to you.
See, it works for the major investor… which isn’t you.
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The problem of bought-off politicians goes back well before Citizens United. The thing is that politicians can run on red herrings like gay marriage or climate change. The big money will happily pay for their ads, but then big surprise when they get in they suddenly learn to moderate on the issues they had just whipped their supporters up into a froth over. Meanwhile, moderation goes out the window when they all vote to get us into a war that will only benefit sellers of $1 million Tomahawks.
If the people had more granular control, they at least wouldn’t be able to run these sideshows the same way. Right now, they sweep the big issues under the rug — fiscal insolvency, imperial overreach, pervasive rent-seeking, exploding pensions — while telling their supporters that the world will be a better place if we just get bathroom equality or defund planned parenthood. If voters could decide issues directly, then their propaganda would actually have to deal with the issues.
Of course, the masses don’t appreciate complexity and don’t want to hear about it, and that is possibly the bigger problem with democracy. Either way, the slate needs to be swept clean.
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8) Due to a culture of litigation – sue someone any time an outcome is unfavourable – huge resources paid into the medical care end up in the hands of lawyers and malpractice insurers. Malpractice insurance in the US is an order of magnitude greater than elsewhere and is a significant portion of a health care providers overhead.
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I think the malpractice issue varies regionally somewhat. Here in Texas it’s hard to sue a doctor, and there are pretty tight limits on the damages. So I’m told that malpractice insurance costs less here. For other places, I’ve heard some pretty high numbers.
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Good post Alan. Also don’t forget medical device costs and operating costs for everything from machinery to operating rooms.
Take MRI machines for instance. Here are a couple of interesting links:
– Why Does an MRI Cost So Darn Much?
http://time.com/money/2995166/why-does-mri-cost-so-much/
– How much does it cost to operate an MRI machine?
https://www.quora.com/How-much-does-it-cost-to-operate-an-MRI-machine
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Point #5, to expand a bit more on the insanity of contract doctors. My son goes to the ER, to a hospital ‘in-plan’. The on-call physician is a contract doctor, who we come to find out after the fact is…. not ‘in-plan’ WTF! We get charged for full price being out-of-plan. You now have to ask the ER doc if he/she is in-plan? Sheesh!
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You have to ask if EVERYONE associated with medical care in a hospital is associated with your plan. You have assisting surgeons/nurses during operations, anesthesiologists, asistants to the assistants and on and on.
And unless you get something in writing (or perhaps surreptitiously record the conversation on your cellphone), you will still have no recourse if they decide to bring in out-of-network help when you are unconscious!
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“Why is it that every other First World nation spends so much less on health care than the US and yet get better results like lower infant mortality, longer life expectancy etc?”
Due to GOVERNMENT GRANTED exemptions from anti-competitive behavior as described at length by financial blogger Karl Denninger. For instance, the fact that Medicare/aid drugs aren’t acquired through competitive bidding allows monopolistic pricing, the fact that if some medical business wants to install another PET scanner in a particular region, thereby making the market more competitive and lowering prices, the current owners of those expensive devices in that region are allowed to vote on whether that is allowed, etc., etc., etc.
This comes from BOUGHT GOVERNMENT. PERIOD. It also answers, as I did above, the question why the US doesn’t emulate a combination of proven to be superior ideas from other nations – there’s no money in it for the effective owners of government, the lobbyists who fund their campaigns, who also offer them cushy jobs when they leave government or six figure speaker fees if they still have influence within government after leaving it.
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Shorter answer – LEGAL corruption to very core.
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@Mish — have you noticed that commenters like webej, realist, “Phil” , HT, Winston, etc all come out at the same time? About the time India gets up? And they all spout extremist left wing nonsense?
They are all part of the same click farm. Probably different IDs for the same 1-2 people. However many it is, they get all their talking points right out of a George Soros training manual.
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Interesting observation there, Medex, although I’m not sure there is much that can be done about trolling. They can and should be banned, but then they just eventually pop again with new names. As long as Soros is going to keep on paying them, they will keep on posting their trash. Mish’s site comments are a lot less trolled than some others.
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What stands out to me is when commentators over interact (as in without trying to assimilate the reader at all ) or when they don’t interact at all ( as in the comments and replies seem framed) . I won’t guess as it will be offensive to be called a troll when not, so I stick to commentators I feel I can relate to.
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“Winston, etc all come out at the same time? And they all spout extremist left wing nonsense?”
I’m not “left” in any way shape or form. How many leftists complain about “the swamp.” How many leftists espouse free market capitalism?
Our government is bought, BOTH parties, and most people who actually investigate in depth realize that. Most just suspect it from what they see. Thanks to that FACT, Trump is simply the “Change You Can Believe In” candidate v2 because most Reps are just RINOs.
Fanboys of one major party or the other will always claim that anyone who criticizes their major party candidate is either a fascist or a leftist. I’m simply a realist. YOUR vote means virtually nothing when it comes to any national topic that has anything to do with a significant change in the status quo flow of large sums of taxpayer funds and new debt accrued on their tab.
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You’re consistent but hard to place, have to expect to be challenged by some – take it as an opportunity for understanding.
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“For What?”
For your entertainment pleasure, ratings…its merely show time!
Better name is Trumpcareless…
“CBO: 24 Million More Without Health Insurance Under GOP Plan”
http://www.nbcnews.com/politics/politics-news/cbo-24-million-more-without-health-insurance-under-gop-plan-n732946
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Since we know the sociopaths in govt will never fix anything until it breaks, we also know where it all ends. I just hope the mob with pitchforks knows the addresses of their pretend representatives and the media propagandist who sold the BS.
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Really stupid on part of the GOP. They shot themselves in the foot. And I think it might be an intentionally inflicted wound. They’ve had the majority long enough in Congress and now it’s time to turn the reins of power back over the the Democrats. It’s all Kabuki Theater, folks. One side helps the other to maintain the 2-party system. And plebes like us end up with perpetual mud on our faces.
Come on. It’s obvious what’s going on here. It’s the old good cop – bad cop routine.
All our healthcare subsidies are going overseas. We don’t have the horsepower to provide decent healthcare to our own people. We have to make sure the rest of the world is taken care of, orders per the globalists.
What a screwed up nation.
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Correct.
The Dems have a growing demographic of government dependents and the Reps pretend to be their adversaries when not in power. Once they have everything they asked for and are actually in power and in a position to change things, they reveal their true nature – basically a phony opposition party which maintains the illusion of voter choice while raising funds pretending to be the opposition.
That’s to be expected since many of the same special interests donate to (own) both parties, pay their pols six figure speaker fees when they leave government, or provide them with cushy, highly paid jobs. Thus, the oligarchy/deep state/swamp, whatever you want to call it, owns both of them.
We will get our way via voting only on issues which don’t significantly disturb the hard won (by lobbyists) status quo flow of trillions (thousands of billions) of taxpayer dollars and trillions more of new debt accrued on our tab. With such VAST sums at stake and with such a generally ignorant and easily propagandized citizenry, how could one expect anything different?
As was said in a quote attributed to anarchist Emma Goldman, “If voting changed anything, they’d make it illegal.” Voting can still get you want you want in small communities. Anything larger, because your voice is smaller and there’s more MONEY involved, forget it.
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It’s not healthy to be intelligent enough to be able to figure all this crap out, Winston. My dad used to tell me as a kid that ‘ignorance is bliss’. I didn’t fully understand the truth of that statement until I joined the rat race. By observation I began to notice that the stupid people with their EBT cards seemed much happier than the high-brows in their business suits who roamed the concrete jungles. The same ones who collapsed from coronaries at their office desks at age 55. The most frustrating part of being able to connect the dots is realizing that you’re powerless to change any of it. The D’s and the R’s wear different colored jerseys for appearance sake but play on the same team. Thinking one could change the course of government by punching out chads in a voting booth is about as fing naive as believing one could change the temperature outdoors by farting into a windstorm. At the end of the day it really doesn’t matter who’s voted into to office – the outcome remains the same because they all answer to the same boss man. Adversarial political system? My ass.
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LFOldTimer its too early to see how this plays out. The Senate needs a look and then the President (if it ever gets that far).
The only thing of substance so far is that the Democrats are behaving like a bunch of low IQ juveniles. Combine that behaviour with a refusal to disavow the Antifa thugs and you may find there are not many willing to vote for them in the mid-terms.
Disappointing because it is important (for the sake of democracy) to have an intelligent and articulate opposition party that works for the American people – not just for themselves. I’ve never been a one party voter, I vote for the person that I believe is best for the position.
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So much criticism but nobody will step up with their own plan! There is really no such thing as a fair plan because of all the complex variables. Obamacare is socialized healthcare that needs a whole lot more money to work. Certainly nothing new about that. The Obama administration,from what I understand, was pulling billions from different places to keep it afloat until after Jan, 20 2017. Surely somebody has mentioned this already but I haven’t seen it yet. I’m talking about interest rates. With much less debt and normal interest rates this health crisis would b at least solvable. By normal interest rates I mean something like 6% on the 30 year bond, 5-6% on the ten year note and lower on down a positive yield curve. Low interest rates have caused all kinds of malinvestment, public companies taking on over a trillion n debt for buybacks for higher earnings the easy way- stock options-yea go for it boys!! Meanwhile the middle class guy, blue collar worker having saved a couple 100 thousand dollars for retirement expecting 10 thousand a year with normal interest rates gets screwed. In normal times insurance companies also make investments in bonds. But these low interest rates have screwed up the normal way they do business as it’s much easier to make money with normal interest rates rather than have to raise premiums ever chance they get. I didn’t think I’d ever b defending these people, and they not without guilt n this whole mess. Anyway, the problem is we’re not all pulling together as we used to as a country as Americans.I could keep going here but Mish has been right from the very beginning with Benanke, the Fed and QE. We shouldn’t have bailed out the bankers,let the markets restructure the debt and then start over. Now here we r almost ten years later and the Fed thinks now is the time to raise rates looking at 20 trillion dollars!
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Interesting. ZIRP certainly has distorted the economy as we used to know it.
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I suggest you look at health care systems that work well in dozens of other developed countries. There are plenty of plans you can examine.
In my country, the health care system is hardly talked about at all, because it works. I’m not saying it’s perfect, but it works pretty well. Conversations about health care centre around who is going in for what operation. No one talks about cost, or affordability. Because its paid for through the system, which is paid for through taxes.
When Americans ask me about my annual premiums, or how many times I can visit my doctor, or what are my co-pays are, or about deductibles, or coverage limits, I look at them and say what?
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Enjoy it while you can – sadly the relatively recent phenomenon of state-funded universal healthcare is not going to last. Eventually you run out of other people’s money – especially as the population ages.
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Good point. In fact, the aging demographic is putting strain on our health care system already. I suspect the % of gdp devoted to health care will have to increase over time as a result. But since this % is significantly lower than in the US, it seems to me we should be able to absorb the burden for quite some time.
I also hold out hope that technological innovation will not only improve medical care, but reduce costs over time as well.
For those who may have noticed my previous posts regarding autonomous vehicles, I believe that this technology will reduce deaths and injuries from vehicle accidents by close to 100%, which will result in huge savings for health care systems all over the world.
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And robot nurses/MD’s will significantly lower the cost of medical care.
It is inevitable that ever increasing prices is a strong motivator for finding ways to decrease costs. Automation/robotics is and will be the answer.
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We had a healthcare system in place called the ACA (aka Obamacare). Instead of focusing on repealing the existing law, the Republicans should have focused on repairing it. Or if they thought repairing was impossible, then they could have taken a step back and extended another existing healthcare system called Medicare to everyone.
But noooooooooooooooooooo, either of those choices would have been too simple and too sane.
Here’s hoping the Republicans lose BIGLY come to 2018.
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“Here’s hoping the Republicans lose BIGLY come to 2018.”
We’re screwed either way. Stop serving the function of a ping pong ball and don’t vote for either major party.
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What Trumpcare does is to reduce redundancies by encouraging states to take over welfare. 50 experiments will result in far more learning than a one-size fits all solution for a highly diverse country
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Trumpcare is a rebirth of personal responsibility. It has been shown people will NOT take so many chances when people know they have no safety net, So boo-freaking-hoo to those breaking an arm skateboarding or a leg skiing.
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There WILL still be something for the truly sick. America has a charitable quality. And that charity will be more efficient at distributing help than any government agency. Volunteers are MUCH more affordable than government workers who demand above average pay and pensions.
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Charity definitely needs a larger role in health care. Charity is better than large payments to insurers. Charity was nearly banished from Western countries with the destruction of the monastery system, which once provided food, clothes, health care, pharmaceuticals, etc. to the poor. Governments (e.g. England, France) destroyed the monastery system, and for whatever reasons (compassion, politics, etc.) governments assumed the burden in a foolish way. Charitable hospitals should have been considered in any health care bill.
But since Obamacare was a mandatory health insurance scam, not a health care bill, this was not done.
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Ha ha ha! Did forcing people into bankruptcy fall under your “personal responsibility” doctrine?
=======
How the Affordable Care Act Drove Down Personal Bankruptcy
Expanded health insurance helped cut the number of filings by half
By Allen St. John
May 02, 2017
As legislators and the executive branch renew their efforts to repeal and replace the Affordable Care Act this week, they might want to keep in mind a little-known financial consequence of the ACA: Since its adoption, far fewer Americans have taken the extreme step of filing for personal bankruptcy.
Filings have dropped about 50 percent, from 1,536,799 in 2010 to 770,846 in 2016 (see chart, below). Those years also represent the time frame when the ACA took effect. Although courts never ask people to declare why they’re filing, many bankruptcy and legal experts agree that medical bills had been a leading cause of personal bankruptcy before public healthcare coverage expanded under the ACA. Unlike other causes of debt, medical bills are often unexpected, involuntary, and large.
“If you’re uninsured or underinsured, you can run up a huge debt in a short period of time,” says Lois Lupica, a bankruptcy expert and Maine Law Foundation Professor of Law at the University of Maine School of Law.
….
http://www.consumerreports.org/personal-bankruptcy/how-the-aca-drove-down-personal-bankruptcy/
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Nice to try.
Correlation is not causation.
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Nice try yourself. Sometimes it is. Don’t relay on pat sayings as an intelligent response.
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“This is a disaster on-deck with virtually no chance of an upside. Republicans now own healthcare (Trumpcare) whether a compromise bill passes or not.”
Health Insurance = Healthcare? Illogical equivalence. Health care is not the same as health insurance. Furthermore, there is no such thing as Trumpcare except for propaganda purposes, as nothing has changed. House vote changes nothing, as law remains the same. It is all a charade. Democrats cannot pretend otherwise, and voters in majority of states who were not fooled by Hillary and Mainstream Media Propaganda in 2016 are unlikely to be fooled by this. Only when Trump signs something will there possibly be such an animal as Trumpcare, but given the USA Senate divide this will not happen until Obamacare is for all practical purposes extinct (perhaps 2019). Pretending this is real is delusion.
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One thing that seems absent from the whole conversation is the term “free market”.
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Did “free market” work for your telephone service, cable service or airline service? Where is all the choice the “free market” was supposed to bring us?
These days, most of us have very limited choices for any of the the above services. And each service is riddled with fees upon fees upon fees, making it impossible to compare even one choice to another (assuming that you do have two choices).
I have tracked my spending with Quicken since 1995. My cable bill, for example has something like 15-20 lines of charges and fees!
For most people, there is no longer any choice in telephone service, if you want a land line. If you go the cellphone route, then you are basically limited to AT&T, Verizon, T-Mobile or Sprint. All the rest piggyback on one of these services.
“Free market” is a theory that they teach in school but that rarely exists in the real world.
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And why is that??
Because of government.
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O/T but too good not to post.
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The entire ruling elite of France are represented in that photo.
Trousers worn by a foreign leader.
Get up man.
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What’s he doing down there? Did he lose a contact?
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She told him to get down there.
Next picture she told him to try and touch his nose with his tongue.
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No missing contact lens, but it is possible the photo was taken just after Angela was informed that Obama had a wiretap on her phone.
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With bankers printing 10% annual medical inflation, fewer people are going to be treated each year. In effect, bankers are ruthlessly confiscating medicine from people. Everyone is running away from providing expensive coverage, and cash prices are unaffordable for the majority.
This bill was all about 10% medical inflation being unaffordable. Printing is the bank’s war on anyone who needs meds.
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Obamacare is bad but it’s not impossible to create something worse. Eventually we’ll have single payer national health care
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There is no cure for rising healthcare costs if we cover everyone and provide maximum benefits. I know we all want to live forever but don’t want to pay for it. America runs to the doctor for every little thing, we clog our hospitals with people who abuse themselves with drugs, alcohol, cigarettes and overeating. We spend money on laparoscopic surgery, plastic surgery and other costly procedures. We get a CT if we go into the emergency room with a headache. What do you expect rates to do but go up. Now we complain because Congress won’t fix it.
Like everything else, congress will not address the real causes of our healthcare crisis.
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Here’s a detailed account of most everything that needs to be done to fix health care in the US which, basically, means fully introducing free market competition.
Expect none of it to be done:
The Bill To Permanently Fix Health Care For All
by Karl Denninger
https://marketticker.org/akcswww?post=231949
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Correct link:
https://market-ticker.org/akcs-www?post=231949
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Dems convinced health bill jeopardizes GOP’s monopoly in DC
Associated Press
https://www.yahoo.com/news/trumpcare-gop-faces-political-fallout-063712749.html
ATLANTA (AP) — It’s “Trumpcare” now, and Republicans have to answer for it.
After dozens of symbolic votes, House Republicans finally pushed through a bill to gut Barack Obama’s Affordable Care Act, with President Donald Trump hailing the replacement as “a great plan” that has “really brought the Republican Party together.”
Democrats are giddy about what could be severe political consequences for the GOP.
——
Exactly, in the dull minds of too many US voters, by even touching the “ACA”, the Reps will now own it. If any major party would know that it would the Dems who’d know that, “Yes, voters ARE that stupid” because that defines their constituency. As you can see by this article, they are already being aided on that “managed perception” by their lapdog mainstream media.
If this actually passes the Senate, that’s exactly the message the Dems will spew when the “ACA” continues to TANK as it WILL before the 2018 election. If the Reps lose the house, forget most of Trump’s campaign promises which require any kind of funding from ever being realized, but the Reps will be back where the PHONY “opposition party” prefers to be – barking like lapdogs at things that most of them don’t actually dare change because there owners are pretty much the same people who own the Dems.
“No one in this world, so far as I know—and I have researched the records for years, and employed agents to help me—has ever lost money by underestimating the intelligence of the great masses of the plain people. Nor has anyone ever lost public office thereby.” – H. L. Mencken
“The most dangerous man to any government is the man who is able to think things out for himself, without regard to the prevailing superstitions and taboos. Almost inevitably he comes to the conclusion that the government he lives under is dishonest, insane and intolerable, and so, if he is romantic, he tries to change it. And even if he is not romantic personally he is very apt to spread discontent among those who are.” – H. L. Mencken
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The American system of health care delivery and its foreign policy/military interventions perfectly illustrate why the American republic is a beacon of democracy to the world, which has so much to learn from such a great example.
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