To get the healthcare bill out of the Senate, Republicans need 50 votes, with Vice President Mike Pence casting the tiebreaker vote.
The problem for Republicans is they are two votes short as Four Senate Republicans oppose draft of GOP health plan.
Sen. Rand Paul of Kentucky, Ron Johnson of Wisconsin, Ted Cruz of Texas and Mike Lee of Utah said they opposed the draft legislation for a “variety of reasons,” but they’re still open to negotiation before the bill hits the floor.
“There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs,” they said in a joint statement.
GOP leaders are eyeing a floor showdown next week, after the Congressional Budget Office scores their plan’s affect on federal spending and coverage.
While leaders might broker a deal, efforts to appease the conservatives risk alienating moderates who want to preserve coverage for their residents.
The bill maintains the same basic outline as the House proposal, repealing Obamacare’s “individual mandate” and the health exchanges and replacing them with tax credits aimed at helping those who don’t get coverage through their jobs buy plans on the individual market.
It also provides tens of billions in “stabilization” dollars to help states transition to a GOP model and subsidize sicker and poorer Americans.
Mr. Paul said that amounts to an expensive Band-Aid on Obamacare’s core problem — low enrollment is driving up costs, deterring even more enrollees and making the problem worse. “They don’t fix the death spiral, they subsidize it,” Mr. Paul said. “That’s sort of like saying, ‘Cars are expensive, why don’t we have a car stabilization fund?’”
The best way to deal with Obamacare, once it passed, was to do nothing.
The system is imploding on its own merits, as many of us stated all along.
Rule of Nothing
In any given political situation, the best outcome one can reasonably expect generally happens when politicians do nothing.
Implied corollary#1: When politicians attempt to fix any problem, they are highly likely to make matters worse.
Corollary #2: Politicians almost never do nothing. It’s why we have a messed up healthcare system, education system, public pension system, etc..
A quick check amazingly shows no one has postulated a “Rule of Nothing”, so I get to claim it.
Law of Bad Ideas
Inquiring minds may also wish to investigate the Law of Bad Ideas.
Mike “Mish” Shedlock
The pubs will tinker with Obamacare then own it take full blame when it implodes. Really stupid. So stupid it has to be intentional. It must be time to pass the torch back to the dems so they can regain the majority in congress. Trading favors back and forth assures the survival of the fraudulent 2-party system. The more things change the more they stay the same. Mueller has to get rid of Trump to eliminate the threat of damage to the deep state. He’s hired the best henchmen that money can buy. They know all the tricks in the book. Being new to D.C. and inexperienced in swamp politics – Trump is a sitting duck.
The Senate bill is no better than what the House concocted. But if all they need to do is buy off a couple Republican senators – passage will be a piece of cake.
And we’ll remain the first world nation with the most expensive medical system that offers the worst outcomes.
don’t underestimate Trump. He didn’t get to be a billionaire businessman by being dumb-and a lot of our Congress men/women aren’t that sharp.
Mueller is a joke, the investigation is a joke, and nobody cares. You can’t start a war if nobody shows up.
I hope you’re right.
But I suspect you’re wrong.
I think you underestimate the power of the Deep State. They’ll squash Trump like an ant, They hold all the cards. They know all the tricks. And they’ll watch Trump like a hawk 24/7. One wrong move and he’s done. They’ll be on him like white on rice. This is a battle of the egos and Trump will lose.
Stuki Moi said:
Trump became a Billionaire the way most current Billionaires did: by happening to own something that “went up” because the Fed pumped it up. He may be a genius, he may be a retard. Most likely he’s somewhere in between, like most people. The results of the Fed dumping trillions on top of the city you happen to own buildings in, has no bearing on it either way.
Most millionaires owning property do not become billionaires, and everybody had the same Fed conditions. What Trump has done is unusual, no two ways about it. Others have started with more money, and ended near zero. From what I’ve read, Trump had some good lessons from his father, a real estate developer who staked him to his start. Socialists would claim government made all business success possible (e.g. infrastructure), which is why we need higher taxes on businesses to enable more business successes. They have a point, as government did indeed make the Fed possible.
Average cost to have a baby at an elite private Indian hospital averages about $240. Average cost to have a baby at a US hospital averages $30,000. A free market would never produce price disparities like this. Special interest groups and bankers have combined to produce prices that are unaffordable for the majority.
Medex Man said:
Are all those Indian citizens living in abject poverty around Mumbai movie extras?
Or are you overselling a health system that only serves a very very tiny segment of India?
$240 is the price for the self pay rich over there who want elite private hospital care. The poor get free care at public hospitals.
$30,000 is the price here. This is an absurd difference. The bottom 70% of voters can’t possibly afford this. These are not free market prices. Indian medics are not free to open a hospital here like Toyota can open a car factory. Americans cannot self medicate with Lipitor from Amazon. Wal Mart can’t train their own medics to their standards, and offer the bottom 70% affordable cash prices.
Medex Man said:
Arguing that the US system is overpriced, inconsistent, too much overhead, etc is a throwaway argument — a truism.
But you claimed the Indian system is better, which is rather ignorant. They have a lower cost of living (which makes prices lower generally). And their “system” simply ignores 90% of the population. They get no care at any price.
And losers who can’t think straight (libtards as they are known in the USA) are easily confused and think the health system India has for the top 0.5% is somehow universal — even though 99% of Indians are ignored.
If we are going to fix the US system, we can’t be making ridiculous comparisons to foreign systems that don’t really exist. You made it sound like India covers all births at $240, which is patently false. That is only available for the richest of the rich.
$30,000 seems high. My 3 kids all cost roughly $5,000.
The BBC had an article that said $30,000, on average:
Maybe insurance paid part of your bill, or negotiated a special deal. Maybe inflation changed the prices since then.
You’re absolutely correct, Ekim. The US medical system is a complete ripoff. The per capita costs are off the charts compared to other 1st world nations and our medical outcomes are worse. This is well documented by WHO and other renown health care organizations.
If you were to pay for a quadruple bypass at a US hospital out of pocket it would cost you $150,000 to $200,000 easy. At a 5 star hospital in India US trained cardio-thoracic surgeons would perform the surgery for about $25,000 cash, to include pre and post treatment.
No wonder medical tourism has increased exponentially in the last couple decades.
BillyBob Texas said:
WHOLEHEARTEDLY AGREE, MISH. Let it die!!
Let the whole country see what a P.O.S. that program was……
Medex Man said:
Anything that doesn’t control costs is the same as Obamacare — guaranteed to fail. The details don’t matter since the plan(s) cannot work. Since they are guaranteed to fail, they are also guaranteed not to pass. Mitch McConnel and Warmonger McCain just neutered themselves, Paul Ryan is already neutered.
Obamacare is still in collapse, and the dems are keeping REALLY quiet because they know they can’t raise taxes or insurance premiums high enough to save it — not without gutting the economy. The Dems are neutered, and so perfectly happy to let the wicked witch of San Francisco drown in her own failure.
After Obama drew his stupid red line in the sand about chemical weapons in Syria — and everyone knew from the start Obama couldn’t back it up — Obama became irrelevant.
Congress is drawing their own red lines in the sand, and everyone knows they can’t back it up. Democrats, Republicans, confused senile men from VT … none of them can control health care COSTS, so in the big picture none of them really matter.
Winston Churchill explained America many years ago. America can always be counted on to do the right thing, after first trying everything else. Tax subsidized employer insurance didn’t work. Universal government coverage (medicare and VA hospitals) doesn’t work (neither does Canada or UK’s NHS). Government mandated insurance (Obamacare) is a ponzi scheme.
The sooner this criminal scam Obamacare fails, the sooner we can get on to having the private sector control health costs — just like it used to do before FDR’s socialism, and just like the private sector does in most other industries.
Try not to act surprised when FDR’s last remaining socialist program (social security) fails like all the rest.
Tony Bennett said:
“Anything that doesn’t control costs is the same as Obamacare — guaranteed to fail.”
Exactly. That’s why a government sponsored solution is no solution.
Only competitive pressure can bring pricing in line with reality. It’s not even a question of left versus right politics.
Stuki Moi said:
The private sector needs to not only control costs, it needs to control the delivery. Believe me when I say that providers are being choked. I’m being audited by two different insurance companies for “overcharging” for patient care. I see some of the sickest people in my community – I do house calls as well as office calls – and my patients are generally very non compliant, and many have been discharged from other practices for this. I spend a LOT of time with them, doing a LOT of education. Since I’ve had these patients, most have not ended up back in the hospital for their chronic illnesses. Yet I’m the bad guy for keeping them out. Penny wise and pound foolish, as always. I could just move them in and out like on an assembly line like most places do, I could just not give a $h!t and let them do what they will, but I don’t. Why? Because I LIVE IN THIS COMMUNITY. These are LITERALLY my neighbors. I’m the only provider around here who actually lives here. It’s maddening.
The “Cowperthwaite’s Rule”.
Don’t intervene and don’t bother looking at economic measures as they will only encourage intervention.
Keep out of the way & don’t delude yourself into thinking you know best or better than the aggregate decisions of millions of your peers that constitute the market.
“He believed firmly that “in the long run, the aggregate of the decisions of individual businessmen, exercising individual judgment in a free economy, even if often mistaken, is likely to do less harm than the centralized decisions of a Government; and certainly the harm is likely to be counteracted faster.””
Stuki Moi said:
The “Cowperthwaite’s Rule”.
Don’t intervene and don’t bother looking at economic measures as they will only encourage intervention.
Despite what the progressively indoctrinated may have been suckered into mindlessly believing and regurgitating; it wasn’t out of oversight, that America’s Founders did not include “compile detailed (pseudo)economic ‘statistics'” amongst Government’s limited powers.
Trump and the republicans were elected to so three things:
1. Build the Wall
2. Leave NAFTA, TPP and the Paris Accord
3. Repeal obamacare
If they don’t do these tree simple things – they are going to lose in 2020
john clark said:
Outlaw healthcare insurance and revise bankruptcy laws to provide consumer protection then let the market discover the value of healthcare services. As long as you have the gummint mandating healthcare ins and guaranteeing profits to insurance cos you have a system that will eat the country alive.
It’s next to impossible to shop for even a routine health care treatment and thru healthcare coding games by care providers nothing is ever routine or standard. You come out of anesthesia and you’re hit with a bill for $40k for some uninsured, out of scope service performed by your surgeon’s golf buddy.
Jon Sellers said:
The medical community came up with the system of pricing based upon procedure, not the insurance companies. And any attempt to reform that system will be opposed by the AMA and AHA. The system insures a lack of price transparency and competition. Insurance companies are just taking a cut. Cut out the insurance companies and the doctors and hospitals will get it all.
Reforming bankruptcy laws would be deeply opposed by the American Bankers Association, as well as the AMA and AHA.
Absolute price transparency. That’s what they can charge. If you can find the code (and you can, there are entire books devoted to it as well as websites such as http://www.icd10data.com, you will know. If they don’t take Medicare they can only charge I think it’s 10% more than Medicare prices or something like that. The problem is that insurance companies pay even less than Medicare does. I get 50% of Medicare rates from one insurance company and 60% from most of the others. Only one pays me 100% of the Medicare rates for my “specialty” (family).
Jon Sellers said:
“The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.”
Yup, perfectly transparent!
Imagine going to fill up on gas and, instead of a plainly posted price out front, you had to go to a website to read this BS. Now imagine doing the same after just suffering a heart attack.
Actually, look at the MAC. That’s your local area. And you want to look at non facility pricing for a private practice that isn’t owned by a conglomerate, and facility prices for those that are owned by hospitals. It is pretty transparent for govt crap. And frankly, people should be looking this up BEFORE they need care. It might induce them to actually take care of themselves instead of depending on a pill and a procedure to take care of it.
Number One: Obama Care was passed when no one bothered to read what they were voting for. It requires a super majority to revoke it as law. What are the odds of that happening? We can’t really ignore it since the temptation of get quick lawyers will find some way to make money out of suing any and everything over it.
Number Two: Forget trying to control costs. That is what Obama Cara does now. Congress in its wisdom had ignored, encouraged, all of the many monopolistic practices in the healthcare industry. It has allow trusts and combines that seek to extract at any unfair advantage they may use to steal every last penny for those who would use healthcare services. We cannot have competition while we seek to “control” prices. It’s competition, stupid.
Number Three: The public demand a lot of folly. It is in their nature. But give them healthcare that is dependent on competition and they won’t need healthcare folly. If there is one thing the government should leave alone, it’s the public’s bodies. Remove as many barriers to competition, including limited medical school enrollment. Get government out of the healthcare industry as much as is practical.
Number Four: See number Two, Enforce the damn laws. There are both federal and individual state laws on the books today that prohibit monopolies, monopolistic practices, un fair practices, deceptive practices, trusts that are against the public interest, combines, and the like. There have been since the start of the 1890s. These laws have not been repealed. They are simply ignored by our various attorney generals. It’s called graft and extortion and we have laws against that too. If we want rule of law then we must demand it all the time.
Medex Man said:
Number 1: false. Obamacare didn’t pass. It was jammed through with slimey parlimentary procedures and bribes.
Number 2: Are you high? Obamacare is a sick pyramid scheme. It encourages doctors to leave the system (restricting supply) while encouraging Obama’s free sh!t army to demand more and more “free” care (increasing demand). Are you on crack, or do have trouble grasping basic supply and demand? Is there a kindergartner near you that can help explain things?
Number 3: Obamacare puts more and more government into health decisions, which is the opposite of what you are now saying. Face it: if the taxpayers pay for your uterus, than the taxpayers (not individual women) decide what happens with their uterus. Obamacare basically overturns Roe v Wade using power of the purse to do it.
Whether we like Obama care or not, it was passed into law. so no, number one was not false and to “kill it” or remove it from law will take a super majority in both houses.
Number Two, yes, Obama care sets prices through the insurance companies as far as what those companies are willing to pay. you are talking to someone who took courses in healthcare management but never got the degree (no one would hire a fifty plus white male for a healthcare management position, fact of life). I know how prices are set and why. I know that doctors who belong to HMO and such are pushed to prescribe needless and expensive procedures. Healthcare is run amok with waste, greed, deceptive practices, poor quality care, the list is very long. Obama care merely supported the crime against humanity. so what’s your point? That I’m too dumb to know anything compared to the brilliance of your reply?
Okay, so Obama care puts government into more and more healthcare decisions and tends to excludes the patient. Well, well, well, what else is new? If i remember correctly, Roe V Wade was about taking government out from between the doctor and his woman patient when discussing abortion (read the care, it did’t “Legalize” abortion per se). Did you know that both federal and state regulations regarding the training of doctors is highly regulated and serves as a barrier to entry? did you know that that barrier was started back about 1900? Name any medical procedure that the government isn’t a partner to?
Now I can understand your disagreement with what I have written, but why did you turn it into some kind of personal assault? What was your point?
Medex Man said:
Bribing members of the Senate to vote for something is not passing a law (see Bob Kerry Nebraska for the most glaring of many examples).
Using House – Senate “reconciliation” measures — because everyone knew the scam would fail if either part of Congress had to rewrite their versions… that is ambulance chaser crap.
It didn’t pass into law by legitimate means, not even when the dems were running both house and senate. And the scamming and lying was so bad the dems lost control (it certainly wasn’t that the reps had better ideas — voters wisely put that witch Pelosi out to pasture.
The nicest thing you can say (and it would be unethical and deceptive to do so) — Obamacare was jammed into law using at least two technicalities and some legal trickery.
And to answer your really stupid question, you are lying. Lying does not get you respect, it makes people think you PERSONALLY are a loser, on top of your support for a crime masquerading as a law. You keep lying, and people will keep telling you so. Your lying is personal, its about you as an individual. YOU LIED.
You have so many axes to grind, my goodness. and since I neither feel the way you do about how and why Obamacare passed, nor share your version of your truth, then I must be a liar. How convenient for you. Yes, when one knows exactly what the truth is then all others must be liars. Sounds like Marxist dialectics. I thought we stopped pushing such illogical thought thirty years ago. Ah, it must be the fault of the Russians. Yes, that’s the ticket. to put it gently, I would never want your respect for it is meaningless. You live in a world of your own making somewhat apart for the rest of us and you are most welcome to it. I hope you eventually find some peace of mind.
Fully agree. By passing anything, the Republicans will now accept responsibility for whatever happens. Propping up bad ideas is itself a bad idea.
Let Puerto Rico crash. Let Illinois crash. If the banks screw up again (and I am sure readers here have their own viewpoints on that particular issue) then let them crash. Let Obamacare crash.
And when Congress is finally called to account by really angry voters, let them crash as well.
We have to have faith that the market system will adapt and overcome if the politicians will simply let it happen.
ANYONE at this late date who thinks progressives will be held accountable for their insane policies, simply has not been paying attention….at ALL.
The progressives (and their media) are already blaming Republicans for creating “doubts” about existing ACA.
Republicans owned this the moment they rejected and predicted it’s demise, so let’s stop pretending that Republicans have any choice.
The issue is one of expectations, the idea that healthcare is a RIGHT and as such has NO market restraints. Health insurance is wealth redistribution, ultimately, if we are willing to be honest, primarily taking from those who earn and giving to those who consume. The battle in Congress is to find creative ways of liberating those needed funds from earners without them noticing.
Unless we are stupid we know that competition is the only sustainable means of cost control and also know that politicians will NEVER take anything away from “poor people” which is taken to imply all of us.
Progressives have continually sought to increase demands of entitlement by the people, KNOWING it would crush the economy while demonizing anyone who resists or attempts to preserve their own personal wealth. Alinsky all the way. The communist playbook. Healthcare is their strongest weapon, conservatives wanting people to DIE.
Walter Fair said:
One of your best.
Sent from my iPad
john clark said:
Rs are approaching this with the mindset that “anything will be better than O’Bcare”. Not necessarily.
They’re going about this bassackwards and will create a monstrosity that will further enrich the normal lobby interests, the Dems uniformly voting no on anything the Rs propose is a saving grace as long as there is a handful of sane Rs voting with them.
Jon Sellers said:
This bill cuts deeply into support for the middle class and poor, but thankfully provides significant direct funding to insurance companies while reducing taxes on stock market gains.
Buy stocks of insurance companies and hospitals and sell grocery stores.
I wouldn’t get near hospital stocks if you paid me. As the poor lose healthcare coverage over the next several years, the poor will once again use the emergency room as the preferred choice of medical care. Hospitals will be back to where they were 8 years ago, in red ink trying to shift cost of covering the uninsured.
I agree. Anything that can be labelled as greedy by the socialist segments of society are a bad investment.
Medex Man said:
You meant to say this bill (which has 0% chance of passing, unless they use the same crimes Pelosi used) reduces empty promises for the poor. That is, it doesn’t promise free sh!t to welfare types — you know, the people you folks in San Francisco pushed out of your neighborhoods.
YOU (losers from San Fran) displaced the poor, and then you have the nerve to complain other people aren’t paying enough to fix your mess? And you still keep sending that criminal Pelosi to Washington because she really does represent your evil selfish lifestyle
Bill Riley said:
Mish, as usual, spot on. I used to say something akin to the Rule of Nothing–Don’t just do something, stand there.
If Congress is in session, you have to sleep with one eye open as they are sure to make things worse unless they rip everything up that they’ve already created. And you can bet folks will argue, if government shuts down, that it’s costing us money. Let me get this right, we’re 20 trillion in the hole and running deficits while government runs but we shut it down and we’re not saving money? Nothing is better than something when it comes to these clowns.
Glad to see Senator Johnson taking a stand as I wrote to him 4 months ago that the Republicans have tethered themselves to a bomb that had counted down to 3…2….1 before they were choosing to pick it up, wind it back a mere few seconds only to have it now go off while they hold it, such that the fools will then blame them for its destruction upon the masses. The he-who-touches-it-last theory…
So simple, it needed no touching whatsoever. The bill on its own was a disaster…it was affordable only its is name, nowhere else.
Housing, health care, education, first they inflate it to enrich those they want to enrich, then they complain about affordability. The wealthy get wealthier as they own assets tied to the bit 3 the poor get subsidized, and the rest either get punished into becoming the poor ultimately subsidized or they desperately try to survive long enough to hold an asset that keeps the above it–until the asset bubble busts, then the bottom gets larger again.
The Rule of Nothing is another Mish classic.
Carl R. said:
The number one thing that needs to be done to create an efficient system is to cease to allow healthcare to be sold as an employee benefit. Allowing corporations and governments to include it as a benefit has doomed it from the start. Why? Because, it removes it from free market forces. If your healthcare is a payroll benefit, the laws of supply and demand no longer apply because costs are irrelevant to the employee. They no longer care what a procedure costs, and they no longer ask the prices. We don’t bundle car insurance into employment, why should be bundle healthcare?
It’s because of the tax benefits that individuals and companies get. It results in paying less in taxes when a company provides health coverage.
Jon Sellers said:
Medical pricing isn’t structured that way. It is based upon the action performed by the physician and you can’t know what that is until the physician decides which action to perform (with the exception of routine exams of course). That’s why you can’t know what the price is going to be. This system helps maintain pricing power for the medical community by reducing transparency and competition, and is strongly supported by the medical communities lobbying groups.
It is also supported by the insurance community and their lobbyists because they have the resources to negotiate the hundreds of billing codes across a large-swath of the medical community and take a cut of the differential between their negotiated prices and what you pay them.
Win-win for both doctors and insurance companies.
However, you need help negotiating with insurance companies for your actual pricing. Insurance companies also have armies of lawyers dedicating to make sure their contracts with you are as one-sided as possible in their favor. This is where you need the sophistication of your employer’s resources to help negotiate not just pricing but contractual terms for care. Most individuals simply don’t have the bench strength of healthcare attorneys to handle those types of negotiations.
So it is not really the fact that employer’s provide insurance that is the problem, it is just a symptom.
And this is the Free Market at work. Doctor’s/specialists/hospitals are free to charge whatever they can negotiate with you/employers/insurers. Insurers are free to charge whatever they can get away with, and you/your employer can pay the insurance and doctor’s of your choice.
The pieces that are not free market are regulations around pre-existing conditions, Medicare/Medicaid/TriCare, but those are only for specific individuals. Obamcare/Trumpcare will both be dead soon enough.
Stuki Moi said:
“And this is the Free Market at work. Doctor’s/specialists/hospitals are free to charge whatever they can negotiate with you/employers/insurers.”
In a free market, the supply of providers wouldn’t be restricted. Anyone, from anywhere, could set up shop. Selling anything from anywhere. To anyone. For any price. Entirely unimpeded. Any procedure, any medicine. Wherever he could obtain it. Doctors, nurses, equipment manufacturers and hospital building crews from India, bringing Indian generic drugs with them, etc. Heck, if whatever they do over there keeps people alive in that overcrowded pressure cooker, it can’t be all that bad….
Otherwise you end up with just another racket. That uncritical, and not too bright, pumpers, can pretend is some sort of a “market.” Like “real estate.” Another so called “market” where magically, in exact opposition to any genuinely free market, prices keep going up, despite efficiency inevitably getting better year over year. And via the exact same mechanism as healthcare getting more expensive: The entrenched and connected, reducing competition. In order collect unearned usury.
Carl R. said:
There are lots of places that are not free market. Another place is that there are regulations on what has to be included in a policy. In any case, when I go in for my annual checkup, my doctor discusses with me the pricing for various tests he could run, and we decide on which ones to do. The same for various treatment situations. It CAN be done this way.
I do agree that Obamacare/Trumpcare will both be dead soon enough. Remember, though, that when government action fails, the only possible solution is more government action, so the replacement will have to be a single payer system. It remains to be seen, however, if that will take the form of a new program, or we will creep towards that goal with an ever-expanding medicaid system.
How does the proposed plan lower health care costs?
Reducing health care costs is not what the bill is about. It’s about reducing taxes for the wealthy and limiting/lowering the amount of federally mandated payments. Simple as.
By making it too expensive.
Tony Bennett said:
It is unfixable. It will be the demise of the republicans if they try. It will also be their demise if they don’t since they have been bitching about it from day one There are only two viable solutions; completely repeal the POS and just expand medicaid the way obamacare did to cover those who need it supposedly the poor. However the feds will have to figure out how to pay for it. The problem is many people on the free medicaid program game their employment purposely to avoid the income ceiling that would disqualify them. This leads to poor productivity and an economic drag. The other way which I know you favor so highly, lol, is to do a single payer system and finance it with a national sales tax so those working under the table will contribute their share. If you examine any other country with a single payer system you will see they have better health and lower costs about 50% on average. Yes there are problems with it but less than our system. The facts speak for themselves. Going back to no insurance like you favor is to late, that horse has left the barn.
Another option is to actually lower the cost of health care. One obvious way is to allow prescription drugs to be imported.
Stuki Moi said:
And ditto for health care workers.
They could not let Obamacare implode on its own because that would take time. They wanted to repeal it so the subsidies could be used to balance the huge tax cuts for the rich they are going to pass next.
This is not a health care/insurance reform bill. This is a tax cut disguised as health insurance reform.
“They wanted to repeal it so the subsidies could be used to balance the huge tax cuts for the rich they are going to pass next.”
So, why didn’t they? One word – “RINOs” – followed by four – “a majority of them”.
They cut Medicaid by 800B – and that will fund their tax cuts. If they cut too much from the others, they know they are screwed in the next elections.
Even the Republican politicians know that single-payer is inevitable. It is only pathetic Democrats like Clinton, Feinstein and Pelosi that believe it won’t happen.
Jon Sellers said:
Dems are even more on the take that Reps. It costs more to buy off the people who are supposed to be looking out for you.
And, BTW, the VAST majority of lost tax revenues from the proposed tax cuts come from a cut to our high corporate tax rate which serves to attract more businesses to the US:
A 15% corporate tax rate could be very expensive
“For example, the Tax Policy Center estimated in November that Trump’s 15% proposal, coupled with a repeal of the corporate Alternative Minimum Tax, could reduce revenue by nearly $2.4 trillion in the first decade.
To put that in context, that’s about $240 billion a year”
The effective corporate tax rate has been falling for decades. And so have the corporate tax revenues.
We are always just one more big corporate tax cut away from trickle-down finally working for everyone, huh?! Hundreds of millions of people in the US and across Western Europe are not buying that cockamamie theory anymore.
Everyone in Europe except Ireland. It worked over there and of course it pissed of the EU. Common sense, if you want business to stay in your country make it attractive for them to remain. The European Socialist Union can’t do the math. Perfect e.g. is IL the more they raise taxes the less they get. See the Laffer curve. The taxes not paid by corporations have to go somewhere else and its better off if it doesn’t go to the useless govt idiots who piss it away.
The Laffer Curve is an international joke. Here is the real Laffer Curve: https://www.rgbrenner.com/blog/2015/01/06/california-kansas-can-teach-us-laffer-curve-tax-theory/
The taxes not paid by corporations go somewhere else – they go to repurchasing stock at any price so insiders can cash out their stock options and make out like bandits.
Come up with some new BS. The old one doesn’t fly anymore!
The article proves nothing. If you maintain a leftist ideology it will justify your theory. For people like you facts never get in the way of formulating an opinion You might know there are many variables not accounted for in that article. Someone should send the article to the Irish I guess they didn’t get the joke.
Stuki Moi said:
The “Laffer curve” is most certainly just simplistic salesmanomics. All of “Macro” economics is. Macro economics is to economics what astrology is to astronomy, after all….
But the idea that people are somehow better off, by having more of their money taken from them at gunpoint rather than less (or none), is even more ridiculous than any sales pitch even Arthur Laffer could dream up.
And yes, taxes not paid by corporations go somewhere else: To the people that provided funding for whatever venture the corporation is in, in the first place. Which, assuming a free market, is a good thing. Since the fact that a company makes money in a free market, means it offers a service worth more to people, than the cost to produce it. I.e, it is generating value. Beats the heck out the money going to some thug with no other qualification than asymmetric access to more guns than the rest.
In a non free, pervasively manipulated, non-market; all attempts at economic reasoning obviously breaks down. Which suits the thugs just fine, I suppose. In places like that (meaning America anno now), profits are almost exclusively due to Fed transfers and government regulated usury. So it may well be “better,” along some metric, to take some from this guy and hand to that guy, without anything in the way of a clue. There is simply no way to know, and no metric along which to judge “better.” So it’s all just chicklets screeching that “they themself” “deserve” more than their siblings. And that mommy should take for the others and hand to them.
But the problem that hence needs fixing, is the lack of a free, competitive market allocating resources properly. As in, get rid of the Fed. Get rid of restrictions on individual freedom extending much beyond the Ten Commandments. Get rid of restrictions on individual freedom arising from a government much larger than Jeffersons. Done. Solved. That’s the goal. Not trying to second guess whether some “corporate” leach deserves to have “his” money taken by some apparatchik leech. Both while doing their darnedest to perpetuate a “society” so broken, it makes Taliban Afghanistan seem like a positively enlightened place.
“The best way to deal with Obamacare, once it passed, was to do nothing. The system is imploding on its own merits, as many of us stated all along.”
And it was best to do nothing not just because they’d only screw it up further, but for POLITICAL reasons. The Dems will try to blame the Reps for its failure no matter what, but now that it is called Trumpcare by the vast numbers of idiotic minions it makes the Dem’s blame game easier.
“The bill maintains the same basic outline as the House proposal, repealing Obamacare’s “individual mandate…”
The individual mandate is the worst part of Obamacare as far as I’m concerned.
Reblogged this on World4Justice : NOW! Lobby Forum..
If there ever was a specific example of Congress serving lobbyists at the expense of the citizenry, this has to be it. Individual access to medical care is getting worse and costs are escalating at an alarming rate due to unfair business practices and uneconomic subsidies. The problem is so severe that the insurance companies cannot increase premiums fast enough to keep up without vaporizing their enrollment. What does the newly elected Republican Congress do about this? They vote to shovel even more taxpayer money into this raging furnace.
There ought to be more than just 3 other senators with Rand Paul’s position. The fact that there is not is shameful.
Free market for health care can’t possibly work as well as a more centralized system, for the following reasons among others:
1) Rationally planning ahead is difficult to impossible, many conditions are unforeseeable, as are accidental injuries.
2) Consumers totally lack domain knowledge and have no realistic ability to assess the cost/benefit of various treatment options. Even doctors routinely fail to achieve this, except in centralized systems (like the NHS) which expend great effort to standardize treatment pathways and disseminate best practices down the chain.
3) Voluntary insurance leads to adverse selection. If the young and healthy don’t pay, there’s not enough money to cover the old and the chronically ill. So either you force everyone to pay or accept that many old and ill people will go without treatment.
4) The big one – we’re not willing to deny treatment to those who can’t pay, leading to mass death in the streets.
The U.S. system costs so much because of 1) excessive administrative costs due to fragmented and inefficient system, 2) profiteering by drug and medical-device makers, and mainly 3) a failure to devise standardized diagnostic and treatment pathways based on careful analysis of effectiveness and cost-benefit, and force providers to follow these pathways. All of these points can be addressed by greater centralization, none of them in the least by greater “patient choice”, whatever that means.
Stuki Moi said:
1) You know that is exactly, uhh, what insurance is for, right? Most people don’t really do much planning ahead wrt their house burning down, either.
2) The human body is a complex entity. So yes, consumers are working off of, at best, educated guesses. But so are everyone else. Most certainly the baby-kissing contest winners leeching about down in Congress. A cool property of self interested individuals, is that they have motivation to study up on those things that matter to them. Much more so than than the motivation the average babykisser have to study up on what matters to anyone but himself. So consumers can be relied on to seek the best advice they can obtain. From those most qualified to offer it. Then decide whether the cost/benefit is worth it. As in, some of them have been known to call an electrician when their power is out, rather than sitting on their hands babbling about how “we” “need” a centralized electrical “system.”
3)Whether the young and healthy take out INSURANCE or not, has exactly no bearing on an insurance scheme’s ability to cover someone else. Since their actuarially correct premium would just cover their own risk, anyway. It’s not like insurance covering Everest climbers are somehow dependent on a million people whose climbing is limited to climbing into bed once a day, “paying in.” To the extent insuring me depends on you taking out insurance, we are no longer talking about INSURANCE. But rather just theft. Taking money from you, and handing it to me. IOW, right back to the same old progressive Newspeak trick of obfuscating crass theft, by attempting to cover it up with petty, feelgood complexification of terms. Aimed at no more than fool the well indoctrinated, uncritical, and not so bright.
4)For one, there are no “We.” Never has been, never will be. That out of the way: Most people are rarely even in a position to offer much treatment to anyone. If someone is bleeding to death at my doorstep, you’re right; I’m not willing tot deny him a bandaid. I would assume the same holds true for most. If he is dying from something much more complex than that, I’d make some attempt to get hold of someone I believe can offer a broader range of treatments. But most dying people don’t hang out at other’s doorsteps. Nor in the streets. And the fact that some do the latter, is on account of lack of individual freedom in the real estate so-called “market”. Rather than excessive freedom in the, equally regulated hence dysfunctional, health care so-called one. In reality, people die all the time from preventable causes. While the “we” “won’t allow” blowhard talk, is just yet one more example of petty Newspeak. The only systemic way to make health service overall better for as many as possible, is to make rendering it as efficient as possible. And the only known way to improve efficiency of processes, is to expose them to competition. In the real world. Not in some model nor five year plan. Competition where the efficient beats out, hence replaces, the inefficient. And gets rewarded for it. Rinse and repeat. Which always happens when people are free to choose. And never happens, when they are not. There’s nothing special about selling bandaids, pills and sutures, vis-a-vis fishing lure, cocaine and tow ropes. And no, things are never diiiiiferent thiiiis tiiiiime.
Jon Sellers said:
“For one, there are no “We.” Never has been, never will be.”
There, you and I will disagree Stuki. Without “we” there can be no “I”. Humans evolved over 250,000 living in small tribal communities utterly dependent upon each other for survival. Humans cannot live without that community. It is not in our genes.
If you don’t believe, take a ride up the Amazon and disembark from the nearest human as far away as you can, and see how long you last. There is only ‘we”. Always has been and always will be. The rest is politics.
“Humans evolved over 250,000 (yrs.) living in small tribal communities utterly dependent upon each other for survival.”
In the ANIMAL WORLD! My God, haven’t you realized that what worked in the animal world doesn’t work in a modern technological world? That those behaviors are the cause of the vast majority of man’s problems.
There are serious problems with man’s animal world:
Might makes right gives you all the death and destruction of government – 300 million killed and trillions of dollars of wealth destroyed in the 20th century.
No concept of other’s property puts anything you earn/create up for grabs by those in control – including you.
No free market leads to a return to nature’s economic system: zero-sum economics, or how those tribes survived.
I’m convinced that one’s morality is what a person believes is the best way to survive. Surviving like a savage is the opposite of surviving through peace, freedom, and prosperity.
As for your cutesy Amazon example, that does not mean you have to be OWNED by society. Voluntary interaction is an aspect of civilized behavior.
Was the first flaked tool or first wheel made by your tribe? No, it was an individual, probably with Asperger’s.
Stuki Moi said:
Perhaps more precisely: There are no arbitrary group of “we,” that is somehow accurately spoken for, without each and every single one of the individual I’s first being consulted.
As someone who has seen some of the inner workings of the US medical system over the years, I could not disagree with you more. The original system we had decades ago, strictly fee for service, worked better and was more effective.
Giant centralization only leads to corruption, inefficiency, incompetence, and inaccessibility.
Also, a large portion of medical needs *is* foreseeable and has to do with personal choices. Diet, drug use, social behavior, exercise, responsible treatment of disease (i.e. administering treatment in time and on schedule). People are free to do what their heart desires and I believe individual liberty is to be preserved. If you believe that too, then it is perverse that you advocate I must be forced to pay for the consequences of my neighbor’s poor decisions. *Some* medical conditions are not foreseeable or within a person’s control, but that is not what is bankrupting the system.
The US is suffering from Federal micromanagement on so many fronts in so many obvious ways and yet people like yourself call for *even more* centralization as a remedy. No thanks.
I would like to agree with that but at this point I see no way of that happening. Do you honestly think eliminating insurance and going back to fee for service will fly in any way?
I think it might be possible to go back to something similar to fee-for-service if it is structured correctly.
First off, fee-for-service and medical insurance should be two separate issues. When one buys fire insurance for a house and the house burns down in an unexpected fire, the insurance proceeds are used by the homeowner to rebuild or whatever, paying whoever the homeowner selects. That is a good example of insurance.
With medical care today we do not have “insurance.” What we have is a distributed medical payment plan where those with low medical needs are forced to pay for those with high medical needs. That is not insurance. It is a form of social welfare (I am calling it by its proper name, not saying whether it is good or bad).
I think any system that is going to work must have a few key features:
1. Prices must be publicly posted and be the same for all who use the service. No more secret prices and no more “the price depends on how you are paying.” Existing antitrust laws should be enforced.
2. Unless one is on welfare, one should be able to buy true medical insurance to help pay medical costs if one elects. If one has insurance when one has a bona fide medical claim, then one would be examined by an insurance claim agent to verify the claim was real and the insurance would pay a cash benefit that can be spent at the patient’s discretion (like an auto claim). No potential for doctor faking claims and giving a kickback to the patient.
3. If one is on welfare, then welfare provides a basic medical care allowance. The allowance would be for basic care and would not be enough to cure exotic or expensive problems (palliative care only in those cases). The amount would be set according to an independent analysis of what basic medical care costs and if that benefit is not used, it would accrue to the individual, similar to one’s annual social security statement. The accrued amount would not taken away when one gets off welfare, however it could not be spent except on medical care with claims verified the same way as in #2, above.
That would be good start. Do I think it will happen? Probably not.
4. Regarding existing conditions: One cannot buy insurance for a loss that has already occurred. Consequently, a person would not be able to purchase medical insurance for an medical condition after the problem had been diagnosed. This is a painful reality, but one cannot by homeowner’s insurance after the house has already burned down either. The best I can think of to deal with this problem is there needs to be affordable payment plans to help people. In the ancient fee-for-service days, many doctor’s provided this payment service directly. If one could not pay then perhaps a person could at least go on welfare and pledge their medical welfare allowance for care.
Polly Wannacracka said:
Corollary #3: Politicians are good for nothing and they should stick to what they’re good at.
Alex Spencer said:
Rule of nothing = well said. For corollary #2 it helps to have an activity for the politicians to keep busy working on something that has no impact on the people’s lives. Bimbo eruptions provide a break from spending eruptions. See reductions in deficit during later Clinton. Looking forward to various Trump investigations scaling back new political initiatives.
Unfortunately it looks like the constant investigations are now subverted as smoke screens for really bad legislation to be passed as well.
l. brody said:
Mish, your rules are the best
Free market solutions are currently evolving right under the noses of our bureaucrats. Walmart offers $4 prescriptions for most generic drugs. CVS pharmacy offers cheap outpatient care offered by Nurse Practitioners. My local hospital could insure me for a low monthly fee (oops, not allowed by State insurance overseers. The free market could offer very creative and cost effective solutions if only the bureaucrats would get out of the way.
Every attempt to fix the US health care system is doomed to failure because the political parties will always undo what the previous government did. Whatever Trump care turns out to be it will be worse than Obama care. Whatever comes after Trump care will be worse still. American politicians spend so much time and money fighting each other, that things keep getting worse.
I will predict that by the end of Trumps term, America will increase the percentage of GDP spending on health care, and cover even fewer people. This will hurt the middle class the most.
I also predict that America will never move to the single player systems that work so well in many countries. This is because Americans have been brainwashed by their politicians into believing that those systems don’t work. American politicians remind me of politicians in communist countries who feed their populous a pack of lies about how great their country is, and how awful every other country is.
I have just returned from a trip to China. Their half hour newscasts always follow the same script: 10 minutes of communist party propaganda about how much they do for the people, 10 minutes about their wonderful economic growth (which is true by the way), and 10 minutes of news about all the horrible stuff happening in all the other countries in the world (which is true as well, though often exaggerated ).
By the way, Chinese medicine is extremely interesting. It is primarily about healthy living and eating, herbal remedies, exercise, meditation, and balance in your life. Prevention is most important. Treatments tend to be long term (ie no pills for instant results). Though the younger generation tends to want the pills and instant results, unlike their parents and grandparents.
I’m not advocating for Chinese health care, but I am saying that we need to be more open minded regarding our health care.