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Obamacare repeal/replace (or 2.0, or Obamacare "lite")


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Chalup, I don't think stubbornness or inflexibility has much to do with it. It has more to do with political realities. For the conservative members, they can't just cave in to a plan or risk primary challenges- this is why you saw some of the more Tea Party types on the House bill dragging their heels. But they're not even really the problem, because at the end of the day, after they made enough noise, they all ended up going along with Ryan's bill.

The problem is more so the moderates. The opposition right now in the Senate is mostly from the moderates, not the right. People like Cruz are quietly OK with it (mostly because he got in his sneaky amendment). You do have Rand Paul in opposition because the bill "isn't conservative enough," but like I explained above- I suspect that's all a smokescreen and BS. The reality is, he represents KY, a state that very heavily relies on the Medicaid expansion, and he's not stupid- the new bill disproportionately affects states like KY and he's gonna have to answer for that.

No, it's the moderates that are the issue, but it's not because they are inflexible or stubborn or whatever. It's because they represent more liberal areas of the country and the new bill doesn't do much to fix Obamacare, it arguably just makes it worse, and really deserves its name of "Obamacare-lite." So voting on this would be suicide, especially for senators like Susan Collins. If the GOP had a larger majority in the Senate, then there'd be cover for some of the moderates to vote no, but as it is, it's a razor thin margin and McConnell can't afford any defections.

You talk about a missed opportunity, but there was no opportunity. This is the point I've been trying to make on this- there was no opportunity on health care. The problem is, the GOP put themselves into a corner with health care, because there isn't, and never was, a realistic GOP alternative to Obamacare... seeing how Obamacare itself was the original GOP plan. This is why I've been so critical of McConnell and the GOP on this, because while they would only admit this behind closed doors, there never was a plan, all this negotiating over 5 months would end up leading us right back to where we started, which was entirely predictable and I called it back in March. They knew this, and so I don't know why they decided to take on Obamacare when there was other low hanging fruit for the picking. What the GOP should've done is just ignore Obamacare, let it collapse and then take up the issue sometime after the midterms and quietly cut a deal on it. As it turns out, that's probably what's going to happen anyway, which begs the question of why the GOP wasted this whole year on it.

Finally, you're sorta painting the Democrats as some blame-free, noble people in all this, and there was some 'high ground' approach here, but dude... you're being naive. Schumer had 0 reasons to negotiate with the GOP, none. Dems have all got their own marching orders, Chalup, and it does not help Schumer right now to have the GOP fix Obamacare by picking off Dems, and then Trump gets a huge win and he can claim he made America great again, even if he didn't do sh-t. No, it's far better to just let it fail and then blame the GOP for not being able to fix it, and then the GOP will blame the Dems for the original bill, and then we're back to just finger-pointing and screaming. But why not? Schumer rather have that, than have the GOP get a win- after all, he's from a safe seat, and so are most Dems, so who cares if the whole thing collapses, just as long as they don't get the blame for it. Plus, you talk about radical base- well, Schumer has his own issues to deal with on that end. The SJWs are so hysterical about Trump right now, there are maybe a couple of senators that could actually be seen publicly working with the GOP without facing the histrionic, rabid SJW mob. Jon Tester from Montana, maybe McCaskill from Missouri... that's pretty much it.

So no, Dems were never going to come to the table, not on this. The outcome we're seeing is the only outcome that was ever going to happen, and like I said, the worst part about it, is that the GOP knew this was how it was going to play out. Given that, this year should've been spent on shifting the national debate to some other issue and getting legislation out on something like trade (and then just quietly dealing with Obamacare at a later time). That would've been a smart move, since forcing a vote on trade would've put a lot of Dems in a tricky spot, especially some of those from rust belt states that aren't particularly in favor of free-trade. Schumer would have a lot less control of his people in that case, especially with senators like Tammy Baldwin from WI or Joe Donnelly from IN.. both up for re-election in 2018, and Trump can just demagogue the sh-t out of those races, in old manufacturing red states where trade is a very sensitive issue. Schumer could badger them all he wants, but those senators aren't voting against a trade bill before an election year, and so it'd force Schumer to come to the negotiating table with McConnell.

That's the point I'm making Chalup. There is no moral high ground or anything, for either the Dems or the GOP, it's just politics, it's all politics, it's the game of thrones in DC- that's all it is, and right now the GOP isn't playing it very well. For someone like McConnell, who was supposed to be a shrewd operator in playing the game... color me disappointed.

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This is going off topic here, so out of respect to the actual topic, I will put this into spoiler tags for people like Tex who want to see my response. Those who don't want to see it, can choose not

...well I guess it doesn't matter. Cancer is generally slow moving and Nuclear war with N Korea will be much quicker.

Because that is the entire fucking point of insurance of any kind. That has always been the case and always be the case. You don't buy insurance after you need it, but before hand in case you ever d

I think that the GOP could have repealed and replaced Obamacare if they'd really done it - well not the way they went about it - differently.

There was never a way the GOP could've repealed/replaced. It was never gonna happen. See my post above to Chalup and my last couple posts on this.

 

The votes weren't there and they never were gonna be there. The outcome we got was the only one possible.

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So basically, we're just kinda stuck with Obamacare or some version of it; that's about as conservative a plan you can practically get through Congress. And the thing is, behind closed doors, the GOP knew this. So why was this the issue that we had to draw the line in the sand on?

 

Why? The same reason why the democrats will be a very long time in retreating from appeal to race and gender based identity politics, no matter the cost to them long term. Because you reap the returns where you most heavily invest. The Tea Party propaganda machine has been screaming to the heavens for years now about how Obamacare was supposedly "socialized medicine" and was precisely what Hitler did when he came to power and yada yada yada. The propaganda machines always begin with the intent of steering public opinion in directions more favorable to the party line, but so often finds themselves under the control of the monster they create. The base's appetite for red meat becomes insatiable, and media outlets and party machines at the ground level need to either deliver or get replaced, especially when both the media and the electorate have become as sorted and gerrymandered as they have. So Tea Party cranks set the agenda for the G.O.P, SJW cranks set the agenda for the dems, and the 85% of the population who are smart enough to reject both idiot extremes, but not smart enough to catch on to how those extremes became so influential in the first place and thereby reproduce their tactics, are left scratching their heads and wondering why the country is going to hell in a handbasket.

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Well, I sorta already addressed that. I don't think the base really would care that much Kurgan:

Yeah yeah, I get that the GOP had been promising repeal/replace for years, but who cares? The base doesn't actually care about Obamacare. They don't even know what's in the goddamn bill anyway. The only reason they hated it is because the GOP successfully attached it to Obama and they don't like Obama. Plain and simple. But Obama is not in the White House anymore so who cares?

If the GOP had to do something, they could've just staged a symbolic vote back in February, let it fail and then move on. Or really they could've just said they'll take it up later and sidestep the issue, and sure, maybe some of the Ayn Rand dweebs would've b-tched, but so what? What are they gonna do, vote Dem? Yeah sure, just like Blacks are gonna start voting GOP if the Dems don't throw them a bone too, LOL ya right.


If the GOP absolutely has to do something, then they can just hold a straight repeal vote in February (it would fail). A lot of people, such as in right-wing media and the like, were pushing this anyway, the "repeal on day 1 vote". It would fail, and the GOP could move on. We'd be in the exact same place we are right now, except with the benefit of not having lost 5-6 months.

 

But I think the GOP could just get away with doing nothing at all- just say you'll fix it later when you got time, and open up Congress with something like immigration or trade. Cause like I said, the dirty little secret is no one in the base gives a sh-t about Obamacare. They don't even know what's in it, what the bill does, the history of the individual mandate, any of that. All they know is Obama passed it, and Obama is bad. That's all it was ever about. Yeah, some people are miffed about rising premiums, but that could be addressed by a back-room deal with Dems after 6 months when no one is looking. Then you got the libertarians who have a legitimate philosophical beef with the individual mandate, but honestly, no one cares what they think since they have no power in the party. The average Republican doesn't really care, and the proof is that pretty much the entire establishment supported the individual mandate, or some variation on it, until Obamacare was passed and it became the easiest way to attack Obama. It more or less was just a fill-in word for "I don't like Obama," when you wanted to sound less petty and wanted to pretend like you actually knew something about policy, and anything and everything could be blamed on it. It really was the gift that kept on giving for 8 years, and had Clinton won, the GOP would be using it for years to come. All sorts of sh-t could be blamed on it, even if it had nothing to do with health care, and people would've ate that sh-t right up.

 

The Dems had their version of this as well during the Bush years- Iraq. You talk to any Dem circa '07-'08, and Iraq was pretty much the worst atrocity since the goddamn Holocaust, it was all they could ever talk about and wouldn't shut the f-ck up about it. Name a problem- blame it on Iraq. Whether it has anything to do with Iraq or not, doesn't matter. Bring the discussion back to Iraq. This was the Dems playbook for over 5 years... but then Obama was elected and.... poof! Suddenly overnight no one was talking about Iraq anymore and it was like it never f-cking happened! Never mind that Obama vastly expanded the security state through NSA programs, didn't close Gitmo, only ended Iraq 3 years later, significantly ramped up the Afghan conflict, and substantially increased the use of drone attacks.... hmm... where did all these code Pink type people, and all the pacifists and the anti-war protests, and all that sh-t, where did it all go?

 

I'll tell you where it went. Dems never actually gave a rat's ass about Iraq. They didn't like it because it was a GOP war and they didn't like Bush. Obama's wars? Afghanistan, drones, NSA projects, etc.? Ask your typical liberal who wouldn't STFU about Iraq about some of that stuff, and you'll get the same answer 99% of the time: a shrug of the shoulders and "meh."

 

Obamacare is the same goddamn thing Kurgan. Just like Iraq didn't end in 2008 and literally zero Dems gave a sh-t, Obamacare didn't have to be addressed this year either, and no one in the GOP would actually care. If the GOP opened up with some big bill on trade or infrastructure or immigration, or whatever.. that would immediately suck up all the oxygen in the room and everyone would've forgotten about Obamacare. Don't believe me? Remember when the travel ban executive order was passed early in Trump's administration? That's all anyone could freaking talk about for like 2 weeks... no one even remembered that Obamacare was out there. Even now, the Dems can barely stop talking for 5 f-cking seconds about that stupid pretend Russia sh-t to even remember that the GOP is working on Obamacare and they gotta say something about that too.

 

No Kurgan, Obamacare was a GOP choice. There was a different way to handle it, and the GOP leadership declined, and now they're paying for it. They got literally one thing through on the agenda- Gorsuch. Maybe if they're lucky they'll get a tax cut passed with the budget in Sep/Oct. But that's it. That's all they're gonna get these first 4 years.

 

What a f-cking goddamn waste.

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I agree with everything you said, except for the fact that the Republicans have quite possibly killed Obamacare just by engaging in the little farce. The ultra-conservative wing gets to show that they tried to kill it, the moderates get to show that they tried to get something better, and in the meantime they've dragged it on so far that Ohio currently has no insurers lined up for 20 counties.

 

In a way, they've hastened, if not directly caused, the failure of Obamacare without any of the political danger of actually tearing it apart.

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I agree with everything you said, except for the fact that the Republicans have quite possibly killed Obamacare just by engaging in the little farce. The ultra-conservative wing gets to show that they tried to kill it, the moderates get to show that they tried to get something better, and in the meantime they've dragged it on so far that Ohio currently has no insurers lined up for 20 counties.

 

In a way, they've hastened, if not directly caused, the failure of Obamacare without any of the political danger of actually tearing it apart.

 

Maybe, but I've seen some Hill insiders suggest (and I think they're on to something here), that McConnell and Schumer will just cut a back room deal later to stabilize the exchanges when nobody's watching. Maybe as part of the upcoming budget/debt ceiling fight- it can be quietly placed in a larger bill.

 

The thinking goes like this- while both the Dems/GOP can just let it fail, the GOP then becomes vulnerable to attacks along the lines of "you didn't do anything to fix it, you're ineffectual/worthless in Congress bla bla," while the Dems become vulnerable to attacks like "well, your law sucked and it failed because Obama is bad bla bla bla." Neither side ends up looking good, so McConnell and Schumer will come to the realization that it's in both of their interest to just get rid of the issue, so neither side has to talk about it anymore.

 

Actually, they've probably already come to that realization, but they're not gonna cut a deal until people have moved on to something else so they can save face.

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And one more thing on that- if that is where we end up, that's OK. And most Republicans won't care either, especially establishment Republicans, and even more so if the GOP can get through legislation on something like tax reform. Outside of the libertarians, there are few Republicans that actually care that much about health care, or are even read up on this complex issue and fully understand all its intricacies. Opposition was never about the bill, it was about demagoguing the issue and riling up the base by attacking Obama's legislation. If we get stuck with the bill, then LOL... whatever, it was a Republican plan to begin with! So I don't care, and while no one will admit this publicly, few other Republicans do.

 

What I do care about though, is the game of thrones, and how McConnell just got outplayed by Schumer. For all his supposed congressional wizardry, apparently McConnell couldn't go over a simple whip list back in Feb and realize that no matter how this cookie crumbled, he was gonna be 2-3 votes short. So given that, I fail to see what political advantage was gained by spinning our wheels on this thing for 6 months just to end up where we started. I dunno, maybe he thought Susan Collins and Shelley Moore Capito could be bought off with some pork or something. And if there actually was a legitimate GOP alternative to Obamacare, they probably could've been, but it looks like we're not going to get there.

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I'm just here to what happens to the Carrie/Kurgan mutual admiration society now that she disagrees with him.

I'm just here to what the what happens between the this and that.

 

Yep, I'm the kind of guy that picks the low hanging (on the ground) fruit after hours in the sun. They call me Douchebag. I prefer Captain Douchebag.

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The Dems had their version of this as well during the Bush years- Iraq. You talk to any Dem circa '07-'08, and Iraq was pretty much the worst atrocity since the goddamn Holocaust, it was all they could ever talk about and wouldn't shut the f-ck up about it. Name a problem- blame it on Iraq. Whether it has anything to do with Iraq or not, doesn't matter. Bring the discussion back to Iraq. This was the Dems playbook for over 5 years... but then Obama was elected and.... poof! Suddenly overnight no one was talking about Iraq anymore and it was like it never f-cking happened! Never mind that Obama vastly expanded the security state through NSA programs, didn't close Gitmo, only ended Iraq 3 years later, significantly ramped up the Afghan conflict, and substantially increased the use of drone attacks.... hmm... where did all these code Pink type people, and all the pacifists and the anti-war protests, and all that sh-t, where did it all go?

 

I'll tell you where it went. Dems never actually gave a rat's ass about Iraq.

Could have been. The upper echelons of the democratic party have long showed themselves to be heels-dug-in neo-con lite, appropriately of the Clinton family mode. Hillary was among the most hawkish Secretaries of State we've yet seen, and a lot of democrats in congress did vote for the war. So I think you're correct in as far as the democratic establishment is concerned. That said, I don't think the war was ever actually all of that popular within the democratic party, especially after the initial pretense for which the war was fought - weapons of mass destruction - turned out to be a complete bust. Public opinion turned against the war, and liberals led the way on this. So there's some truth to what you're saying, but I don't think the liberals simply stopped giving a sh!t about the war once Obama took office, and Obama did receive some criticism for his continuation of Bush era hawkishness. This turned out to be a contributing factor to Hillary's defeat in 2016, I suspect. Trump managed to get a good portion of the Bernie crowd due to his talk against free trade combined with criticism of ongoing interventionism abroad. A portion of the left could not lend their support to Hillary due to her history of support for a number of neo-con initiatives.

 

The response of the democratic mainstream and the liberal establishment to these progressive defectors reveals what their true priorities are. The Bernie faction - the so called brocialists, the dirtbag left as they're coming to be known as, were initially tarred as "Bernie Bros" - implying that they consisted mainly of young white "dudebros." Ass swatting fratboys, basically. They might not have been intentionally racists (of course they were unintentionally very racist, as all privileged white males are) themselves, pinned a thousand editorials written almost exclusively by young women in "leftist" sources such as the HuffPost, the Guardian and Salon - the totally alternative, not corporate media, but in enabling a racist to win the election they were absolutely as bad, and thus as guilty as the most ardent of Trump supporters. Because apparently being a well connected, wealthy and powerful neo-con is quite alright so long as you have a democrat party membership card, dark skin and/or a vagina. Of course, one need not have a vagina to be a woman in this day and age, but I digress. The "progressive" media establishment described above will give you a completely free pass, even if in actual policy you end up making Donald Rumsfeld look like Noam Chomsky.

 

As for actually criticizing Obama, well, I really don't think they actually liked or agreed with the Iraq war, unlike the Clintonesque big-wigs in the party - but come on! This is America's first black president! And to criticize him for any reason is RACIST, and would be giving succour to the Tea Party types. Regardless of what Obama's critics on the right believed (to be fair, a lot of it was nonsense), it would simply be unacceptable to agree with them because they're Republican and, much worse than being Republican, many of them were Christians and, much worse than being Christians, many of them were - get ready for the unspeakable horror of horrors - they were - gasp - shock - horror - they were WHITE MALES! So if opposing ongoing hawkishness on part of the DNC would mean criticism of the first black president and who would hopefully be the first woman president ... well ... sorry, Iraq. I guess it's bombs away! And what the hell, why not go for Libya and Syria while they're at it. No one will whine and moan about it like they did when Bush was president. Not so long as the president has dark skin, or a middle eastern name, or a vagina. That would be white male privilege, wouldn't it? The deep state would much rather have had Hillary Clinton as president, because now that it's Trump, the overwhelmingly "progressive" media establishment might actually criticize him for the hawkishness that he ran against but we all know damn well we're going to see out of him. What the deep state wants, the deep state gets. But it's easier, so much easier, if you have a president the media won't criticize for the same reason the media won't criticize something like, say, an all female reboot of Ghostbusters or a female Dr. Who - no matter how bad she is, a PC cultural climate insulates her from the kinds of criticism that no one would hold back on if it were a crusty old white male conservative.

 

As a corollary to all of this, notice what a monstrosity the very national security state and middle eastern wars are to a lot of "alternative" center-right commentators - think Stefan Molyneux, Lauren Southern, Milo Yiannopoulos, etc - because Obama had supported them during his campaign. Down the memory hole goes Bush's initiation of a good bit of that. And now that said alt-light have been critical of the FBI's investigations of Trump's supposed collusion with Putin, we're now seeing the HuffPost crowd - upper middle class single women, west coast or eastern sea board, supporting mass Islamic immigration (nothing says female empowerment and tolerance like Sharia law. Just ask Linda Sarsour or the SPLC), praise the FBI, the CIA, the deep state and other organs of the national security apparatus that were for time out of hand public enemy #1 to the left. But now that Trump's against those things ... down the memory hole. We're at war with Eastasia stupid, not Eurasia. We were never at war with Eurasia, you silly SJW, or you silly cuck, as the case may be. Get with the program already.

 

I think that's what it's really all about with the democrats in a way that isn't directly comparable to the GOP stance on Obamacare. For the GOP, Obamacare was the kind of horror of horrors that the concept of white male privilege is to the democrats - ready for it - Obamacare was - gasp - shock - horror - Obamacare was SOCIALISM! Even if it wasn't, really. Their propaganda machine had built it up into this evil red bogeyman, and failure to at least give the appearance of acting on it would have been unpalatable to the base, however much their stance may fly in the face of political reality. I still think this is why the GOP made the repeal or replacement of Obamacare the priority that it was, and why I personally don't think the Iraq war would be the best comparable policy to the democrats. That will end up being something like, say, Trump's so called travel ban, or something like that. Something that speaks to what's truly important and essential to the democrat core constituency, and that would be something to do with racial identity politics.

 

Thank God for Chapo Trap House. That's all I can say.

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I think that you are overstating the degree that identity politics matters. There's a huge faction of either party that just isn't going to disagree with their president. Because no one in their tribe will do anything wrong, and so the leader of the tribe must be doing things for the right reason.

 

Bush invaded Iraq for oil, but in every other case, we need to spread democracy. And Republicans that I know really believed that we needed to spread democracy to Iraq, but when it came to the Arab Spring, and an Obama presidency, any action by the US is wreckless and will just destabilize the region.

 

The reality is, America is an insanely religious country, but the gods of America are the elephant and the donkey, and if you worship the other, false, god, you're a heathen who is unable to be saved.

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Maybe, but I've seen some Hill insiders suggest (and I think they're on to something here), that McConnell and Schumer will just cut a back room deal later to stabilize the exchanges when nobody's watching. Maybe as part of the upcoming budget/debt ceiling fight- it can be quietly placed in a larger bill.

They may, and likely will. McConnell already threatened that they'll have to work with the Dems. But even if it makes it through, is it going to happen in time? It takes time to get these things set up, for both companies and states. If we reach a point where it's September and they're just getting around to it, I don't know what will happen. Maybe some insurers already doing business in the state will agree to cover these counties, if they absolutely know that the Republicans aren't going to turn around and screw them. But it really does depend a lot on the timing of any agreements. An agreement that's too late is as bad, or worse, than nothing.

 

Currently, insurers have until September 15 to decide where they're offering insurance and inform the feds. That time could be extended, of course, but even if it is, that'd be a lot of scrambling to get things set up for a November open enrollment, or even a January coverage start date.

 

And the people who are going to be hit hardest are the Republican voters. The bigger counties that tend more liberal are going to have coverage opportunities.

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The Dems had their version of this as well during the Bush years- Iraq. You talk to any Dem circa '07-'08, and Iraq was pretty much the worst atrocity since the goddamn Holocaust, it was all they could ever talk about and wouldn't shut the f-ck up about it. Name a problem- blame it on Iraq. Whether it has anything to do with Iraq or not, doesn't matter. Bring the discussion back to Iraq. This was the Dems playbook for over 5 years... but then Obama was elected and.... poof! Suddenly overnight no one was talking about Iraq anymore and it was like it never f-cking happened! Never mind that Obama vastly expanded the security state through NSA programs, didn't close Gitmo, only ended Iraq 3 years later, significantly ramped up the Afghan conflict, and substantially increased the use of drone attacks.... hmm... where did all these code Pink type people, and all the pacifists and the anti-war protests, and all that sh-t, where did it all go?

On a tangent, this was hilariously bald-faced hypocrisy. A blatant display of "It's different when our guy does it." MoveOn had a email survey of the direction they should take after Obama's election and everything was so heavily slanted towards the Democrats' agenda. (This, actually, brings them full circle to the intent of its founding.) In the survey I added their silence was deafening on the issues they brought against Bush's administration.

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THIS is my problem with it:

 

'

That's the point I'm making Chalup. There is no moral high ground or anything,

for either the Dems or the GOP, it's just politics, it's all politics, '

 

I know I'm childishly naive about How Things Are, but this makes me sick to the pit of my soul.

 

There are SO many issues that can be all politics and this is NOT one of them. I really want somebody

in politics to acknowledge this and no, I'm not holding my breath. I know that we must deal with

situations as they are, not how we wish them to be, but this is one that will affect people's very

immediate lives. That it is a political football and NOTHING ELSE is so morally putrid to me I can't

even discuss it rationally. I mean, if we're CHOOSING to go down this road, then what the fuck

are we doing keeping alive anyone who isn't a superior human? We should just be honest and work to

decrease the surplus population.

 

Every death for lack of care should be on the hands of every stinking coward who votes for this piece of

shit and they should be reminded of it DAILY, post-vote.

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Well MG, I dunno that the current system actually causes any outright deaths... I mean, it's not like people are literally dying out in the streets like during the Spanish Flu or the Black Plague or something.

 

The problem is more that people get their care via the emergency room since it's the only time they can't be turned away for not having insurance, and then they get heavily in debt with bills they never are gonna be able to pay. Ultimately then, they file for bankruptcy. I can't remember the actual percentage number, but the amount of bankruptcies that are related to medical bills is pretty substantial, might even be a majority.

 

So, I mean, calling it a literal life or death issue is a bit melodramatic, it's more of an economic efficiency issue. Right now the current system generates a ton of private debt that wouldn't otherwise exist, a lot of economic inefficiency (right now there are way more nurses, PAs, assistants, hospital staff, hospitals, etc., than would otherwise be economically viable), a growing and very concerning amount of public spending (that is unlikely to ever shrink), and pretty much everyone across the board loses, except for big pharma, insurers, and health care investors.

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Bullshit.

 

I have three friends, one of whom is my partner, who all have had different forms of cancer.

 

If my gf didn't have her own company to do group rate insurance, as a freelancer (which she was for 15 years) she'd be denied a personal policy with her hodgkins as a pre-existing condition. Even with her group rate she has to pay out of pocket about $800 a pop three times of year for MRI screening because now she's high risk for breast cancer. Luckily we can afford that-- but a lot of people can't and would skip the screening. If her company were to fold for some reason, Obamacare options were not great, but they existed. Without it, she'd be screwed.

 

Another friend had pancreatic cancer a few years back. It has a survival rate that's very low, but she made it through. Her treatment and aftercare were insanely costly and she was barely able to get coverage at the time through her simple job that most 24 years olds have. This was pre-ACA, but what the GOP is trying to do not only dismantles, but sets things back. The insane pre-existing condition suggestions that their plan has tried to float would have likely left my friend unable to be treated.

 

Finally, another friend has a son the same age as mine. The kid had some super scary medical things happen to him that I don't need to get into. If it were my kid, he'd be very lucky cause I have liberal douchebag Hollywood writer's union insurance that pays for everything. My friend had Obamacare because he too is a freelancer. It cost them a lot, (and they'll be paying it off forever] and it's stuff that requires long-term treatment. Sure anyone can get screwed over by the ER's bills after they save your life in an emergency-- but if you need ongoing care and you can't keep up with bills, you get cut off. For some people, that's a death sentence.

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Life expectancy in the US pre-Obamacare was 78.54 years. Life expectancy after Obamacare by 2015 was 78.74 years. Life expectancy generally in the US has been on an upward trend since 1968, when it was 69.95 years. The largest gains were in the 1970s, and it started plateauing in the 78 yr range in the 2000s.

 

It is possible, though I think probably unlikely that the increase in .20 years is attributable directly to policy, and probably more to general societal trends (better diet, education, etc.) and advances in medical technology.

 

But let's assume that entire .20 was due to Obamacare. That is not a statistically large enough number to indicate that there were millions of people just dying left and right and now suddenly everyone is OK. On average, the number of deaths annually is about the same. I lived in the 80s and 90s Tank, and so did you. It did not resemble Stephen King's The Stand.

 

People got emergency care and care for catastrophic injury before Obamacare, and they do now as well, the main difference is who pays for it. In the past it was primarily the patient, although premiums were still going up for everyone regardless. Now, post-Obamacare, there has been some more shifting towards society generally, instead of the individual, and accordingly, premiums have gone up even more. Under a universal health care system, the cost would be shifted even more, and there is an argument to be made that it would actually end up being more cost-efficient by cutting out the middle men. As I said in my post Tank, I am not arguing the "good ol days" were necessarily better. It maybe was for a few, namely insurance companies and health care providers, but society generally still paid the costs in increased premiums. Incidentally, it is still the insurance companies and health care providers that are still benefiting the most from Obamacare.

 

Now for non catastrophic injury, you might be right that there was less preventive care in the old days or long-term treatments, but I'm not sure any of your three examples would necessarily be in a different position, either pre-Obamacare, or in a government run universal health care system. That's where your faulty assumption lies. Take your gf- in the old system, it's possible she would be denied, yes, (maybe not for everything, it would depend), but whatever policy she got would certainly be less comprehensive, that we can probably say for sure since Obamacare mandates policy requirements. What would end up happening is any complications in the future would have to be emergency room care, and then maybe she'd be able to afford it or maybe not. Her eventual life expectancy, it may be lower, it may actually be near the same- really it depends on her particular medical history and I'm not an expert/nor would it be appropriate for me to ask any more details. It would undoubtedly be more expensive though, that we can say with near certainty, and that's why I'm saying this is primarily a question of cost- how much and who bears it.

 

Now assume we were in a government run system, your gf may actually end up in, more or less, the same situation. Depending on how we set up our system, let's say it was multi-payer like France or Germany, well you'd still have those co-pays. They might not be $800, but they'd still be there (hard to know how much it'd be since it's never really been tried in the US). If we had single-payer like in Canada, there wouldn't be copays, but there would be significantly longer wait times and rationing. She may or may not get the full 3 screenings a year.. ideally yes, but, given the size of the US and the fact that you live in LA, which is the 2nd biggest city in the US, and then on top of that, LA also has a significant illegal immigrant population.. well... it could be less, maybe 2, maybe just 1. Again, tough to know, since it's never been tried in the US, but we can look towards Canada and the UK as an example, and they have a pretty big problem with this, with significantly smaller populations than the US.

 

Same thing with your second friend (and similar for your third friend's son), had she not had coverage, it's tough to say how the cancer would've played out pre-ACA, although it undoubtedly would've cost more, since any treatment she got would've been through the emergency room. In a government run system, again- especially with something that is often terminal like cancer, it would be subject to rationing (or what the conservatives derisively call the death panels). In the UK this is done by the National Institute for Health and Care Excellence, or NICE (somewhat Orwellian of an acronym, wouldn't you say?), who uses this formula called 'Cost per quality-adjusted life year gained' to determine whether treatments are performed or not.

 

Now how a hypothetical system would work in the US- I'm unsure, but I imagine it would be based in something similar. Maybe it would also take age into account- a 24 year old with 40 more years of useful working life would presumably be considered differently than a 70 year old (then again, maybe not, since the elderly have such a powerful lobby in Congress, while the young don't care and don't vote, so it would be a particularly sinister twist of fate in a government run system if your friend actually ended up getting passed over in favor of some old dude about to kick it). And I'm not an expert on cancer itself, or how much treatments cost, but what I do know is that cancer treatments tend to be the most expensive and they in particular are what drives the rationing. The UK's NHS budget simply cannot afford to pay for every single person to get the best, state of the art cancer treatment, and so at the end of the day, some people don't get it. I would hazard to guess that the situation would be even worse in the US, since we're already going bankrupt from Medicare, and that's just covering the old folks.

 

So the point I'm making is that in all 3 cases, would life expectancy actually dramatically change depending on the health care system? That's very tough to say, and all we can really know is that in all 3 cases, there has likely been cost savings by increased government intervention, and if there was further government intervention, it's likely it'd be cheaper still. But in terms of actual life or death, we just can't know that. It's entirely possible your second friend, for example, gets rationed out of the cancer treatment she actually got, in favor of something cheaper that was less effective.

 

That's why I think anecdotes like this just aren't that helpful at the end of the day. Everyone has a story about someone they know that got screwed by Obamacare (now they have to pay higher premiums) or how someone got saved by Obamacare (your gf and third friend's son might be examples of this). But you can't draw a lot of conclusions from personal anecdotes. I prefer to look at the bigger picture and nation-wide statistics for that reason.

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Guest El Chalupacabra

I won't "bore" you with my anecdotes, but the Malthusian statistics you tend to cite there go out the window once someone you know and love gets sick, and can't afford to be treated, and dies as a result. We have the money to prop up banks, bail out mismanaged insurance companies, the military, and tin pot dictators, so don't tell me we don't have the money to help people get health coverage. The money exists. Its about prioritizing it. I agree that Obamacare needs to be fixed so that it is sustainable and economically viable, but ripping it out completely is no answer. I would like to see congress trying to deregulate health insurance as a first step before anything else. GOP has advocated for years, since at least Bush anyway, to pass legislation to allow insurance companies to co Pete across state lines the way auto insurance does. Totally different types of insurance I know, but how about starting with that? I think it could work.

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This is the key differences between us. Statistics and math to me take second place to what is morally kind and right.

 

This why I'll never be conservative. This is why the GOP is the party of sociopaths, rich people, and the uneducated.

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I won't "bore" you with my anecdotes, but the Malthusian statistics you tend to cite there go out the window once someone you know and love gets sick, and can't afford to be treated, and dies as a result. We have the money to prop up banks, bail out mismanaged insurance companies, the military, and tin pot dictators, so don't tell me we don't have the money to help people get health coverage. The money exists. Its about prioritizing it. I agree that Obamacare needs to be fixed so that it is sustainable and economically viable, but ripping it out completely is no answer. I would like to see congress trying to deregulate health insurance as a first step before anything else. GOP has advocated for years, since at least Bush anyway, to pass legislation to allow insurance companies to co Pete across state lines the way auto insurance does. Totally different types of insurance I know, but how about starting with that? I think it could work.

 

I wasn't bored by the anecdotes. What I said is they are unhelpful for crafting nation-wide policy, when you have to look at the bigger picture.

 

Sure, we could afford more if we cut spending in all those areas Chalup. Meanwhile, however, I live in reality. The Democrats candidate this past election, you know- the supposed "party of the working class," was a candidate funded by Goldman Sachs, paid over $200k a speech, up to $22mil in 2 years. This was, to me, always the much bigger deal than the e-mail scandal, but did anyone care? (crickets in the background).

 

No, of course not, and that's because to remove those influences Chalup, you would need a revolution, not this weak limp-wristed Occupy Wall Street bullsh-t that lasted like 2 months until it got cold outside, but an actual no sh-t, pitchforks in the streets revolution. And that sure as sh-t ain't happening when people got their iphones and netflix, which is basically the 21st century version of "Let them eat cake." Liberals, particularly millenial liberals, couldn't give two sh-ts how bad they were getting fleeced by people like Clinton, just as long as she said the right things about gays. And blacks. But the fact that people like me were completely raiding the cupboards and leaving them nothing? "Meh."

 

How far Sanders' candidacy went should give you an idea of exactly how likely any change is.

 

So Chalup, I live in reality, where you have to look at stuff like who supports what in Congress, who is voting for what, nation-wide statistics, where are costs coming from, and so on. California is actually a good example of this- I dunno if you've been following this in the news (maybe it's more likely that Tank has heard about it, since he lives there), but they recently tried an honest push to get a single payer system for their state. It was going to be bee's knees supposedly, no co pays, no deductibles, everything and anything was covered, hell even all the illegals got coverage.

 

What happened? Where is it? I thought CA was the liberal mecca, with the enlightened non-deplorables, living in utopia?

 

Turns out, after running the numbers, that to do all of that, either a) taxes were going to have to go way up, or b) rationing was going to have to be so severe that it actually wouldn't be any better than the current system. So the plan quickly failed.

 

And nation wide you'd see the same thing- even if suddenly all this magical money was discovered that doesn't exist, do you think people would actually want something like single-payer? Things we're accustomed to in the US- no wait times, no rationing, having our own private rooms, getting cancer treatments instead of having to go before death panels... you really think people want that? Especially when it means much higher taxes?

 

Yeah, whatever. Take a core member of the Dems' base- again, the "liberal" mecca of CA- say, a software engineer for Google living in the Bay Area. Right now he has health insurance and it's good too. You think he's gonna accept a 20% hike in taxes (when he's barely able to afford the mortgage on outrageous Bay Area housing prices), just so when he gets sick, he can go on a months-long waiting list and then be hospitalized in a shared room with 30 illegals that looks like a refugee camp? LOL, yeah right. (and yes, there would be illegals, since the Dems would not pass anything else, because, you know, racism).

 

No, that guy ain't supporting it when it's the moment of truth and he actually has to put his money where his mouth is. This guy is voting Dem so that his friends don't think he's an evil racist, not because he gives a flying f-ck about people like Tank's friend with pancreas cancer. I mean, do I have to remind you guys that Nancy Pelosi is a freaking aristocrat? She's about as likely to lead any real change as I am to become the next Mozart, just because I like classical music and play the piano.

 

Chalup, I absolutely agree that ripping out the current system is not the answer, but the truth is that premiums are just going to keep going up with Obamacare, any GOP plan (at least the current drafts) won't make it any better, and the Dems are as equally content to "let them eat cake," the only difference being that they throw a bone to the BLM folks, so I guess they're the nicer party?

 

Since outright refusing care in the emergency room (and letting health insurance work like real insurance) isn't a viable option, I think the next best thing would probably be a multi-payer system (or public option), with supplementary insurance, similar to what Germany, Switzerland and Japan do. Heck, I'd even be OK with single payer if it was restricted to citizens and accompanied with a massive decrease in illegal immigrants. But we all saw how likely even a public option was back in 2009 when Lieberman killed it in the Senate.

 

Obamacare, or something like it, is here to stay and it's all we're gonna get for now. That's just the cold, hard reality. So when people like MG bemoan the system and say oh... "There are SO many issues that can be all politics and this is NOT one of them. I really want somebody in politics to acknowledge this" and the system is "morally putrid to me" and bla bla... I'm just like, OK, whatever. If Dems actually cared about any of this, then Pelosi and Schumer wouldn't be in party leadership, a candidate funded by freaking Goldman Sachs wouldn't be the party nominee, and there'd be riots in the streets right now. But no, instead, from most Dems, it's "let them eat cake." The only difference between them and I, is that I'm willing to say it out loud. After all, I'm going to be fine. I can afford it, and if things get bad enough in this country, I'll just move back to Switzerland. But for the poor out there in the US... what can I say? Sucks, I guess.

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This is the key differences between us. Statistics and math to me take second place to what is morally kind and right.

 

This why I'll never be conservative. This is why the GOP is the party of sociopaths, rich people, and the uneducated.

Because everything you just listed doesn't cross party lines?

 

Many of us have situations that hit home in one way or another. Doesn't make us more or less compassionate.

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That's it- it's over. Final vote was just held in a midnight session. And it went down exactly how I predicted it would.

 

Earlier this week, repeal and replace (with the Cruz amendment) failed 43-57. 'Repeal only' failed 45-55.

 

Vote just held on McConnell's hail mary... what was being called, the "skinny repeal," (essentially just repealing a portion, the individual mandate, with the hopes of knocking out a bill in conference committee with the House). Failed just now 49-51. GOP votes against:

 

McCain (Arizona)

Murkowski (Alaska)

Collins (Maine)

 

I was surprised to see Capito and Heller ultimately voted yes. Sort of an epic troll job here by McCain- delayed the vote to have him flown in all the way from his cancer treatments in AZ, just to turn around and vote no. The ol' maverick does it again. Maybe it was intended as a middle finger to Trump, we'll never know. Watching CSPAN for the last hour or so, Pence was out on the floor desperately working McCain, but I guess he just couldn't be bought off. Ironic (and kinda funny, actually) that it was the man who ran against Obama in '08 who ended up being the man that saved his signature legislation.

 

So that's it. McConnell on the floor just now saying they're moving on to the next bill. Obamacare is here to stay. Congrats, Dems.

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Guest El Chalupacabra

Well, I guess you will be packing your bags for Geneva, then, huh? Odd that you get so upset over something that "doesn't affect you."

 

Anyway, I'm not the biggest fan of the ACA, and it does have flaws, but I'd rather it stay in place. On the surface, the Skinny Repeal seemed a decent compromise, but if the vote was that close, there must have been a lot more wrong with it than commonly known. Sure the individual mandate would have been removed (wasn't a fan of that), but 15 to 20 million people would have lost coverage, and insurance premiums would have gone up 20%. I know people like you don't care, but a lot of people can't afford a 20% increase, let alone lose coverage.

 

Oh, and I'm not the biggest McCain fan myself and say what you want, but in this case, he gets kudos from me. Voted no on both repeal only and skinny repeal. Not bad for a guy who literally had brain surgery a week ago for brain cancer. I doubt many other senators, GOP or Dem would have bothered to have shown up to vote one way or the other, after that. Love him or hate him, anyone who would show up after that to give the middle finger to Trump and McConnell gets my respect on this vote!

 

I can't wait to see Trump's forthcoming Twitter Tantrum.

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hahaha nah Chalup, it's not that bad yet. I'm not going anywhere.

 

I'm not upset about the actual failure to repeal. There was no intended "tone of disappointment" with that last post. What I was upset about, and hoping my multiple overly-long posts on this topic would indicate, is the poor politics played by the GOP. That I am disappointed in, especially when McConnell was supposed to be this great congressional strategist and everything. We're in the exact same place we were in 6 months ago and have nothing to show for it. The budget/debt ceiling is up next, and then it'll be the holidays, and then we're right back into an election year.

 

The GOP has complete power right now, the White House and both houses of Congress, but these moments don't last long. It might be 20 years until we get this again. We had a chance to get through an actual big-time bill on something like trade, or immigration, and it's not gonna happen. If we're lucky, we'll get a small tax cut in the budget. Well, whoopee-f-cking do, I'm already rich. I was hoping for some actual structural change in the greater national interest.

 

As far as Obamacare is concerned.. well, as I indicated, what will probably happen (once things die down in a few months and everyone has stopped talking about this), is McConnell and Schumer will cut a back room deal to stabilize the insurance markets since it's in neither party's interest to have this issue still alive for the midterm elections. It'll be a band-aid though, since the structural reasons why premiums keep going up can't be fixed by Obamacare. The mandate with tax penalty has shown that as a mechanism, it's still not incentive enough to get enough people to sign up for insurance, and even if literally every single person in the US did, I still don't think it would control costs.

 

These structural problems are something that will require a much bigger bill at some point in the future, maybe in 10 years or so, when things have reached a breaking point.

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