Healthcare in 2018

cartoon by Jake Fuller via caymancompass.com

Residents in Geneva, New York have been promoting single-payer (i.e., government-run) healthcare as better than healthcare provided by the private sector:

Those supporting an effort to get universal health care in New York — including members of a fledgling organization in Geneva — hope to convince state legislators of the need through the stories of their constituents.

. . .

The goal is to gather information with these surveys to help lobby lawmakers to support the New York Health Act, which would provide comprehensive, universal health coverage to all state residents, and which would replace private insurance coverage.

Coverage would be funded through a graduated tax on payroll and non-payroll taxable income, based on ability to pay. 

These people should be careful what they wish for. Even with the Obamacare mandate eliminated, repealing the entire Obamacare bill remains a legislative priority for President Trump. It should be a priority for McConnell and Ryan, because this is what government-run healthcare looks like (posted at Hannity.com on Jan-03-18):

The United Kingdom’s National Health Service announced this week that it was canceling all “routine operations” until February, saying all “non-emergency” procedures will be delayed after a flu-outbreak left hospitals overcrowded and under-funded.

According to the Telegraph, the nation’s government-run health services axed over 50,000 operations in every hospital in the UK following claims by doctors that patients were being treated as if they were in “third world countries.”

. . .

The chaos comes as prominent Democrats and liberal legislators like Vermont Senator Bernie Sanders advocate for a similar, single-payer healthcare system in the United States. Left-wing advocates often point to Canada and the United Kingdom as an “ideal” vision for the future of America’s health industry.

The NHS is closing clinics, cancelling surgeries, the hospitals are overcrowded, they are even “running out of corridor space,” and there are ambulances lined up outside. 

At present, the Senate does not have enough GOP votes to repeal Obamacare (see here). The elimination of the mandate was a good start, but just a start. I still think that if the exemption from Obamacare currently enjoyed by members of Congress were eliminated, they'd find a way to get the job done.

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Good news on Health Care

 photo credit: Legal Insurrection

Despite the GOP winning majorities in both the House and Senate, and then winning the White House, the pathetic GOPe in Congress have utterly failed to deliver on its promise to repeal the misnamed “Affordable Care Act.” The bill to repeal should have been on the President’s desk on Day 1, but the GOP, it would seem, never dreamed they’d have to make good on the promise.

Now President Trump has signed a few Executive Orders to begin to dismantle the monstrosity known as Obamacare, and Betsy McCaughey reports on what that means:

Trump strikes a blow 

for health care freedom

Free at last! That’s the message for millions who don’t get health coverage at work and, until now, faced two dismal options: going without insurance or paying Obama­Care’s soaring premiums. On Thursday, President Trump announced changes that will allow consumers to choose coverage options costing half of what ObamaCare’s cheapest bronze plans cost.

Democrats are already accusing the president of kneecapping ObamaCare, but these changes will reduce the number of uninsured — something Democrats claim is their goal.

The Affordable Care Act requires everyone to buy the one-size-fits-all package. You have to pay for maternity care, even if you’re too old to give birth. You’re also on the hook for pediatric dental care, even if you’re childless. It’s like passing a law that the only car you can buy is a fully-loaded, four-door sedan. No more hatchbacks or two-seaters.

Trump’s taking the opposite approach, allowing consumers choice. His new regulation will free people to again buy “short-term” health plans that exclude many costly services, such as inpatient drug rehab. These plans aren’t guaranteed to be renewable year to year; the upside is they cost much less.

. . .

. . . Trump has now seized the initiative, after congressional Republicans fell flat on their faces and failed to address the pain ObamaCare is inflicting on consumers stuck in the individual insurance market.

The president should keep going. What’s next? Trump should use his discretion to stop enforcing the tax penalty on those who don’t buy ObamaCare-compliant plans, including buyers of short-term plans.

Then he should cancel the sweetheart deal his predecessor weaseled for members of Congress and their staff members. Even though the Affordable Care Act requires them to buy coverage on ObamaCare exchanges, Obama arranged for them to have a choice of 57 gold plans and have John Q. Public pick up most of their costs. It’s an outrage.

Once members of Congress are feeling the same pain as everyone else, they’ll be more focused on repealing and replacing the dysfunctional health law. In the meantime, Trump is wisely providing relief where it counts the most — in people’s wallets.

Read the rest here.

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Governor Kasich and Senator Portman on Obamacare

art credit: Conservative Review

The Washington Examiner reports:

Ohio Governor John Kasich said Sunday the collapse of the Republican healthcare bill in the U.S. Senate was a "good thing," but was adamant the policy debate was not over.

David Catron at The American Spectator blog named Portman as one of the six Senators whom he describes as liars, frauds, charlatans – well, you get the idea:

The following Republican Senators demonstrated [last Wednesday] that they are liars and frauds: Lamar Alexander (Tenn.), Shelley Moore Capito (W.Va.), Dean Heller (Nev.), John McCain (Ariz.), Lisa Murkowski (Alaska), and Rob Portman (Ohio).

. . . if a Republican won the 2016 presidential election, the same bill [as an earlier partial repeal bill] or something very similar could be quickly passed by a GOP-controlled Congress and signed into law. Every single Republican who ran for the House or the Senate in 2016 made similar statements, including the six charlatans listed above.

These mountebanks, all of whom voted for “clean repeal” when Obama’s inevitable veto made it safe and politically expedient to do so, voted against a virtually identical bill [last week] — knowing full well that President Trump would sign it. In other words, they consciously betrayed their constituents, their party, and the nation as a whole.

At least we know where Kasich and Portman stand.

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Repealing Obamacare: again

YouTube: Right Side Broadcasting

Following President Trumps’s brief speech today (above) in a last-ditch effort to get the Uniparty RINOs to keep their promise to repeal Obamacare, it’s timely to review a couple of reasons why Congress should repeal:

• Medicare is not the answer. Here is today’s horror story about a 91-year old needing treatment but getting rejected by the system.
• Single-payer systems put the state, not the individual in charge of medical decisions. Here’s Mr. Vodkapundit (Stephen Green) on the final chapter in little Baby Gard’s life, and the tragic situation with his parents.

Yet Congress is so used to end-running rules, breaking campaign promises, and disregarding their constituencies that it will be a miracle if they do the right thing on healthcare. How do they keep getting away with it? Here’s an essay by Angelo M.Codevillaon at the American Greatness blog about what “regular order” in the legislative process is supposed to look like. 

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What’s wrong with Rob Portman?

cartoon credit: Walt Handelsman

via US News and World Report / The New Orleans Advocate

Scott McKay at The American Spectator asks:

Do Lisa Murkowski, Rob Portman, and Shelley Moore Capito expect to ever get votes from Republican voters again?

Here’s a question: How long have Republicans been running for federal office on repealing Obamacare, in Senate Majority Leader Mitch McConnell’s terminology, “Root and branch”?

Answer: since 2010.

. . .

You would figure that with Donald Trump in the White House and Republican majorities in the House and Senate, repealing Obamacare would be a no-brainer.

OK, the repeal-and-replace angle could be harder to pull off. That’s understandable. There are lots of different kinds of Republicans, and it might be hard to get all of them to coalesce behind a single federal healthcare policy to replace it. Those of us whose studies of the American public sector have led to an understanding that the less federal healthcare policy there is the healthier the healthcare industry will be have a far simpler solution to that problem, but we are unfortunately not the majority — in the House, Senate or public. That’s a shame, and it’s a symptom of a larger civic disease, but that’s for another column in this space. There will be a replacement for Obamacare, and we can hope it’s less awful than what it stands in for.

But when the Senate version of an Obamacare replacement foundered and McConnell announced the next step would be, early next week, an up-or-down vote for an Obamacare repeal now and the crafting of a replacement as a consensus for one emerges, that’s something an entire GOP caucus can vote for.

Minus Susan Collins, of course; Maine’s quote-unquote Republican Senator wouldn’t vote to repeal Obamacare back in 2015 when McConnell’s majority sent a bill doing just that to then-President Obama’s desk to die. But outside of Collins and Mark Kirk of Illinois, who is no longer in the Senate, the rest of the caucus was on board with the repeal.

And yet Alaska’s Lisa Murkowski, West Virginia’s Shelley Moore Capito, and Ohio’s Rob Portman have now joined Collins in announcing they won’t support a repeal when the vote comes up next week.

What is wrong with these people?

Capito laced her announcement with a special bit of arsenic for Republican voters. “I didn’t come to Washington to hurt people,” she said.

No, Senator, apparently you came to Washington to lie to people.

. . .

What’s wrong with these people? My guess in one word: Uniparty. And the rest of Scott McKay's article is here.

No repeal of Obamacare, again. Thanks GOP.

art credit: huffington post

The GOP members of Congress who put the repeal of Obamacare to a vote dozens of times during the previous administration [per Treehouse, the Senate considered only defunding Obamacare, not repealing], and the GOP candidates who pledged to repeal Obamacare in order to get elected, were all lying through their teeth. They never dreamed that Trump would be elected and that they’d be put on the spot to make good on their promises. And take a look at the two GOP Senators who just announced their intention to vote no! From the AP :

WASHINGTON (AP) — The latest GOP effort to repeal and replace "Obamacare" was fatally wounded in the Senate Monday night when two more Republican senators announced their opposition to legislation strongly backed by President Donald Trump.

The announcements from Sens. Mike Lee of Utah and Jerry Moran of Kansas left the Republican Party's long-promised efforts to get rid of President Barack Obama's health care legislation reeling. Next steps, if any, were not immediately clear.

Lee and Moran both said they could not support Majority Leader Mitch McConnell's legislation in its current form. They joined GOP Sens. Susan Collins of Maine and Rand Paul of Kentucky, both of whom announced their opposition right after McConnell released the bill last Thursday.

McConnell is now at least two votes short in the closely divided Senate and may have to go back to the drawing board or even begin to negotiate with Democrats, a prospect he's threatened but resisted so far.

Some of us had higher hopes for Mike Lee and even Rand Paul. Lesson learned: they are all politicians. And they lie.

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Cartoon of the Day

Steve Kelley cartoon via Townhall

Healthcare & the GOP : Pathetic Fail or Corrupt?

Michael Ramirez cartoon via U.S. News and World Report

The headline:  Pat Toomey says GOP wasn't ready with healthcare ...because they didn't think Trump would win. That’s the conclusion in this Jul-07 report by Robert Laurie at the Canada Free Press:

For some time, I’ve been arguing that the GOP should have had a plan to repeal ObamaCare ready - and on the President’s desk - the week that Donald Trump took office. The ACA’s elimination should have been a day one priority, then you could rest of the year working on healthcare fixes and tax reform.  I’ve heard a whole pile of excuses about why that didn’t happen and I’ve never really bought any of them.

There were only two answers that made sense: Either the GOP didn’t really want to repeal ObamaCare, or they simply dropped the ball and we’re witnessing one of history’s worst cases of political shortsightedness.

While I still suspect there are a lot of Republicans who’d love nothing more than to leave the ACA in place and have the whole issue go away, it sounds more like the GOP just ...failed.  According to [Senator] Pat Toomey (R-PA), no one bothered to ready an ObamaCare repeal bill, because they all thought Hillary was going to be your next President.

He made the remarks during a town hall, hosted by ABC27 in Harrisburg, Pennsylvania.

“I didn’t expect Donald Trump to win. I think most of my colleagues didn’t. So we didn’t expect to be in this situation.

And given how difficult it is to get to a consensus, it was hard to force that until there was a need to.”

In other words; “We could vote to repeal ObamaCare 40 times when we knew Obama wouldn’t sign the bill, but we never wasted our time preparing for the eventuality that we might actually win the next election.”  That’s just pathetic, and it validates a lot of criticisms that Democrats were lobbing at Republicans back during the Obama years.

It’s an admission that their healthcare votes during the Obama administration really were just obstructionist political theater and it suggests that they spent more time preparing for a Hillary presidency than they spent trying to secure a victory.

Remember, they had eight years to ready a repeal, replacement, or fix.  Instead, they put on a big show, yakked about their alleged principles, smiled at their constituents, and kicked the can.

They squandered their time, your money, and our collective efforts because it was easier than getting together on a solution.

No wonder they’re so despised.

My own take: When Senator Toomey admits that the GOP did not seriously prepare for the repeal of Obamacare because they did not expect to win the House, Senate, and White House, he makes the GOP look like fools, but that’s probably better than admitting the truth. I suspect that Laurie’s alternative is correct: the GOP does not want to repeal Obamacare. Nearly all of the GOP, including the so-called Freedom Caucus, are members of The UniParty, and they have already been bought.

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Trumpcare: Senate version -- is Portman against it

photo credit: Pat J Dooley Photography

Update: The photographer points out that the flying banner may be a message TO Senator Portman, not sponsored BY Sen. Portman. If so, apologies to the Senator, and here's hoping he considers it.

[Apparently] Senator Rob Portman hired an advertising plane this afternoon to circle the downtown Cleveland area. He is coming out of the gate opposed to the newly-revealed/leaked Senate version of President Trump and Secretary Tom Price’s healthcare bill. If Portman is opposed to the bill, it is probably a pretty good start to the process of repealing Obamacare.

Conservative Treehouse jogs everyone’s memory: 

The original (’09/’10) ObamaCare bill was 2,700 pages and most of the toxic takeover construct was intentionally and ambiguously deferred to HHS Secretary Kathleen Sebelius where she added an initial 74,000 pages of regulatory and compliance rules and procedures. [Those HHS regulations now total 673,448+ pages and growing.]

Conservative Treehouse also has a fascinating analysis of the Trump healthcare plan. His blog post is worth reading in full, but here’s the very short précis:

Under Trump’s long-term (3 step) approach – the non-government healthcare market, the majority of the population, will break free from almost all of the ObamaCare government regulations; and the insurance market will be empowered to provide an insurance product that fits the individual needs of the person purchasing the insurance.

♦Dual System Approaches – Much like Secretary Mnuchin is proposing leaving government (via Dodd-Frank) attached to the “too-big-to-fail” group of banks and cutting all else loose from the regulations, so too is Secretary Price proposing to leave government attached to the “at risk population” (Medicare and Medicaid), the group 99% of all political talking points are structured around, and cut everyone else loose from the regulations.

•Step #1 establishes the ability (decouples ObamaCare).   •Step #2 allows HHS to frame the parallel system (deregulation). •Step #3 establishes the broader parameters for the non-government health insurance market.

The full pdf file of the Senate bill is here. 

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Coulter on free market healthcare

Image credit: North Country Public Radio

Sorry, I have been off the air for a couple of weeks, and when I got back online this weekend, I found a column by Ann Coulter on HER solution to the healthcare repeal-replace dilemma. Here’s are several extracts and the whole thing (from a little over a week ago) is here.

It’s always impossible to repeal laws that require Ann to pay for greedy people, because the greedy run out on the streets wailing that the Republicans are murdering them.

Obamacare is uniquely awful because the free stuff isn’t paid for through income taxes: It’s paid for through MY health insurance premiums. This is unfortunate because I wanted to buy health insurance.

Perhaps you’re not aware — SINCE YOU EXEMPTED YOURSELVES FROM OBAMACARE, CONGRESS — but buying or selling health insurance is illegal in America.

Right now, there’s no free market because insurance is insanely regulated not only by Obamacare, but also by the most corrupt organizations in America: state insurance commissions. (I’m talking to you, New York!)

Federal and state laws make it illegal to sell health insurance that doesn’t cover a laughable array of supposedly vital services based on bureaucrats’ medical opinions of which providers have the best lobbyists.

As a result, it’s illegal to sell health insurance that covers any of the medical problems I’d like to insure against. Why can’t the GOP keep Obamacare for the greedy — but make it legal for Ann to buy health insurance?

This is how it works today:

ME: I’m perfectly healthy, but I’d like to buy health insurance for heart disease, broken bones, cancer, and everything else that a normal person would ever need, but no more.

INSURANCE COMPANY: That will be $700 a month, the deductible is $35,000, no decent hospital will take it, and you have to pay for doctor’s visits yourself. But your plan covers shrinks, infertility treatments, sex change operations, autism spectrum disorder treatment, drug rehab and 67 other things you will never need.

INSURANCE COMPANY UNDER ANN’S PLAN: That will be $50 a month, the deductible is $1,000, you can see any doctor you’d like, and you have full coverage for any important medical problems you could conceivably have in a million years.

Mine is a two-step plan (and you don’t have to do the second step, so it’s really a one-step plan).

STEP 1: Congress doesn’t repeal Obamacare! Instead, Congress passes a law, pursuant to its constitutional power to regulate interstate commerce, that says: “In America, it shall be legal to sell health insurance on the free market. This law supersedes all other laws, taxes, mandates, coverage requirements, regulations or prohibitions, state or federal.”

The end. Love, Ann.

There will be no whining single mothers storming Congress with their pre-printed placards. People who want to stay on Obamacare can. No one is taking away anything. They can still have health insurance with free pony rides. It just won’t be paid for with Ann’s premiums anymore, because Ann will now be allowed to buy health insurance on the free market.

Americans will be free to choose among a variety of health insurance plans offered by willing sellers, competing with one another to provide the best plans at the lowest price. A nationwide market in health insurance will drive down costs and improve access — just like everything else we buy here in America!

Within a year, most Americans will be buying health insurance on the free market (and half of the rest will be illegal aliens). We’ll have TV ads with cute little geckos hawking amazing plans and young couples bragging about their broad coverage and great prices from this or that insurance company.

The Obamacare plans will still have the “essential benefits” (free pony rides) that are so important to NPR’s Mara Liasson, but the free market plans will have whatever plans consumers agree to buy and insurance companies agree to sell — again, just like every other product we buy here in America.

. . .

Until the welfare program is decoupled from the insurance market, nothing will work. Otherwise, it’s like forcing grocery stores to pay for everyone to have a house. A carton of milk would suddenly cost $10,000.

. . .

STEP 2: Next year, Congress formulates a better way of delivering health care to the welfare cases, which will be much easier since there will be a LOT fewer of them.

No actual money-making business is going to survive by taking the welfare cases — the ones that will cover illegal aliens and Mara Liasson’s talk therapy — so the greedy will get government plans.

But by then, only a minority of Americans will be on the “free” plans. (Incidentally, this will be a huge money-saver — if anyone cares about the federal budget.) Eighty percent of Americans will already have good health plans sold to them by insurance companies competing for their business.

With cheap plans available, a lot of the greedy will go ahead and buy a free market plan. Who wants to stand in line at the DMV to see a doctor when your neighbors have great health care plans for $50 a month?

. . .

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Gov. Kasich’s Medicaid Expansion again

art credit: KUT

Legal Insurrection reports [original links retained]

Full repeal or “roll back parts of ObamaCare”?

The ObamaCare Medicaid expansion is a horrible deal for low income Americans; it’s also where a large number of “newly covered” Americans get their new coverage.

Not only does the expansion include “automatic” enrollment in Medicaid through ObamaCare even if it’s not wanted, but expanding Medicaid to slightly higher income levels includes many who have managed to acquire a home or other assets.  Their home and assets, however, go to pay for their Medicaid bills after they die.  In essence, then, Medicaid functions as a loan from the federal government just as it always has, but because the income level has been raised, more Medicaid recipients than ever will have their assets seized to cover the cost of their Medicaid expenses.

Despite this, some GOP governors are fighting their own party to keep the Medicaid expansion in their states.

Politico reports:

Republican governors who reaped the benefits of Obamacare now find themselves in an untenable position — fighting GOP lawmakers in Washington to protect their states’ health coverage.

. . . .  President-elect Donald Trump heaped more pressure on lawmakers to find a resolution of the issue this week when he vowed to “repeal and replace Obamacare essentially simultaneously” after the Senate confirms Rep. Tom Price, his pick for Health and Human Services secretary.

But Trump’s push comes as at least five of the 16 Republican governors of states that took federal money to expand Medicaid are advocating to keep it or warning GOP leaders of disastrous consequences if the law is repealed without a replacement that keeps millions of people covered. They include Govs. Charlie Baker of Massachusetts, Rick Snyder of Michigan, John Kasich of Ohio, Asa Hutchinson of Arkansas and Brian Sandoval of Nevada.

The governors explain why they want to keep the Medicaid expansion in their states.

Politico continues:

“We are now able to provide health insurance to 700,000 people,” said Kasich, who circumvented his state Legislature to enact expansion in 2013 and who was the sole GOP presidential candidate in 2016 to defend that portion of Obamacare.

“Let’s just say they just got rid of it, didn’t replace it with anything,” he said. “What happens to the 700,000 people? What happens to drug treatment? What happens to mental health counseling? What happens to these people who have very high cholesterol and are victims from a heart attack? What happens to them?”

. . .

Part of Kasich’s argument is that the federal taxpayer dollars his state gets for Medicaid expansion is “our money,” that of Ohioans.

Hot Air explains this is not exactly the case:

Expanding Medicaid, Kasich has said, allowed him to “bring Ohio money back home,” preventing other states from getting $13 billion of “Ohioans’ federal tax dollars” in the first seven years. He circumvented a legislative ban on Obamacare expansion, waving off concerns about the cost with appeals to his experience in Congress in the ’90s.

In just three years, Kasich’s Obamacare expansion cost $11.3 billion, and not a penny of that new federal spending was “Ohio money” that would have otherwise gone to another state.

It’s not clear what President-elect Trump or the GOP Congress plan to do with or about the ObamaCare Medicaid expansion should they indeed succeed in repealing the entire law rather than picking and choosing what parts to to keep and what to “roll back.”

This report can remind voters why they should push Columbus legislators to pass the Ohio Health Care Compact, so that Ohio citizens can decide if they want to maintain or reject Obamacare. Recall that in 2011,

State Issue 3, a public vote on passage of the Healthcare Freedom Amendment in Ohio, passed overwhelmingly in all 88 Ohio counties.  In Cuyahoga County, the Amendment passed 202,010 votes (58.24%) to 144,908 votes (41.76%). [Source: Ohio GOP] 

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