The GOP's best solution on health care
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Author Topic: The GOP's best solution on health care  (Read 2210 times)
Nym90
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« on: January 13, 2017, 03:55:25 PM »

The best thing the GOP could probably do at this point would be to repeal Obamacare and replace it with something almost exactly identical, but with a few minor tweaks/improvements.

That way, they could announce that they had fulfilled their promise to repeal Obamacare and replace it with something else, without actually causing major disruption and chaos in the health care industry and throwing 20 million Americans off health insurance.

Their base, which cares more about slogans/appearances than actual policies, would be mollified that
they had kept their promise and that the evil no-good, very bad thing that is Obamacare is dead and replaced by something "better".

When the media and Democrats try to point out the similarities, Trump can just go on Twitter and say that the "very dishonest media" is lying and that Obamacare was a "disaster" and that Trumpcare is "fantastic" and very different. And he can spend the next four years taking the credit for having saved the US health care system.
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Devout Centrist
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« Reply #1 on: January 13, 2017, 03:59:57 PM »

How do you get the Freedom Caucus to vote yes? How do you avoid a Democratic filibuster?

More specifically, it took months to get the Affordable Care Act passed, let alone enacted. How is that going to be sorted out?
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Nym90
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« Reply #2 on: January 13, 2017, 04:27:11 PM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.
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Kalwejt
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« Reply #3 on: January 13, 2017, 04:33:29 PM »

They would prefer something less complicated.

1. Don't get sick.
2. If you get sick, die quickly.

As Comrade Stalin had said: "no man, no problem".
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Bismarck
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« Reply #4 on: January 13, 2017, 05:36:08 PM »

They would prefer something less complicated.

1. Don't get sick.
2. If you get sick, die quickly.

As Comrade Stalin had said: "no man, no problem".

Isn't this what Allen Grayson said in like 2009? Running out of hacking things to say?
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snowguy716
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« Reply #5 on: January 13, 2017, 05:48:54 PM »

They would prefer something less complicated.

1. Don't get sick.
2. If you get sick, die quickly.

As Comrade Stalin had said: "no man, no problem".

Isn't this what Allen Grayson said in like 2009? Running out of hacking things to say?
Where's the replacement plan?  Running out of diversions?
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Fusionmunster
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« Reply #6 on: January 13, 2017, 05:52:29 PM »

I really don't care what the republicans do as long as they keep the health insurance market stable. If the republicans are stupid enough to repeal major portions of Obamacare with no replacement legislation, increased premiums will be the least of our worries.
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hermit
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« Reply #7 on: January 13, 2017, 05:54:17 PM »


The best solution is Medicare for everyone, with help paying the premiums for those who cannot do so.

It's going to come to this, it's just a matter of time.

Everyone deserves to have easy access to health care and medication at affordable prices.

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Mr. Morden
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« Reply #8 on: January 13, 2017, 05:56:55 PM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.
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Devout Centrist
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« Reply #9 on: January 13, 2017, 06:05:18 PM »
« Edited: January 13, 2017, 06:06:51 PM by Devout Centrist »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.

But do they really think defunding the law will make people think it's the Democrats fault for the ACA's failure?
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Fusionmunster
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« Reply #10 on: January 13, 2017, 06:16:31 PM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.


My worry is Republicans separating the repeal portion and the replace portion into different bills.   
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JA
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« Reply #11 on: January 13, 2017, 06:28:57 PM »

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?
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KingSweden
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« Reply #12 on: January 13, 2017, 06:56:05 PM »

Conservative intellectuals like Philip Klein and others have long pointed out how tying insurance to employment rather than the individual distorts the market.

They all generally also agree that whatever the GOP actually come up with will likely be even worse than the generally shoddy ACA. Healthcare is one policy issue where im staunchly left
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Just Passion Through
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« Reply #13 on: January 13, 2017, 07:33:06 PM »

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?
"Health savings accounts."

Which is a fancy word for "nothing."
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JA
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« Reply #14 on: January 13, 2017, 09:04:32 PM »

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?

Are there no Republicans here able or willing to answer my questions?
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True Federalist (진정한 연방 주의자)
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« Reply #15 on: January 13, 2017, 09:10:32 PM »

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?
"Health savings accounts."

Which is a fancy word for "nothing."
I'm not sure how HSAs would even cover medical costs unless you were rich healthy.
FTFY
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« Reply #16 on: January 13, 2017, 09:17:14 PM »
« Edited: January 13, 2017, 09:24:55 PM by hermit »

I don't mean to be trolling here, but again, there is a plan already in place that seems to work well, and it's called Medicare. Just expand it to include everyone.

Or else, just tweak the ACA. But no, the GOP wants to do it their way, which is no way at all at this point. I can't say that I have any respect for the GOP at this time because they illogically want to put the cart before the horse on this one, but people's health is much too important to be messing with.

Grow up GOP! Get your plan worked out before you kill what we already have that is helping millions of people.

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Virginiá
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« Reply #17 on: January 13, 2017, 09:23:10 PM »

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?

Are there no Republicans here able or willing to answer my questions?

Honestly I take quite a degree of sick pleasure from watching Republican politicians squirm on this particular issue. The fact is, if we lived in a reality where no healthcare reform ever happened, it's highly unlikely Republicans would ever pass anything related to that except tiny little changes here and there. The GOP isn't interested in major reform, and the only reason they are even talking about "replace" now is because it's politically impossible to just do "repeal."

If there was no possibility of backlash, I'm sure PPACA wouldn't be the only thing on the chopping block. It's a shame that many people who actually like/want those programs but vote Republican don't get that.
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« Reply #18 on: January 13, 2017, 11:22:12 PM »

HSAs aren't exactly completely worthless, especially if you get one where your employer matches your contributions, but they are obviously not a suitable replacement. Especially since they are useful really only for emergency-type situations and not chronic conditions. Fine for a broken arm or if you come down with some sort of nasty infection, but not going to do much good to get treatment if you have a chronic heart condition. Also unless you're rich enough to deposit tons in it won't be very useful if you get cancer either.
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Frodo
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« Reply #19 on: January 13, 2017, 11:26:29 PM »

Maybe -another option would be adopt the Wyden-Bennet Healthy Americans Act with some alterations.  Or combine the Affordable Care Act with the Healthy Americans Act, and call it a day. 
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ag
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« Reply #20 on: January 13, 2017, 11:42:26 PM »
« Edited: January 13, 2017, 11:45:35 PM by ag »

I strongly suspect that the actual solution to US health care problem will be to import health care services from Mexico Smiley

I mean, it is almost certain that there will be a big screw-up. First Republicans will happily repeal all the parts of the Obama set-up that make it sustainable. But they will, of course, struggle to repeal those provisions that, actually, make it costly. So, you will wind up in a situation where medical insurance business would, simply, become very unprofitable. Major insurers will retrench, by offering to serve only those segments of the market that are still tenable. Thus, if you work for a large employer, you will still be able to get insurance through a group contract.  If you do not, and happen not to live in MA or another state willing to pass a similar local law, you will either have no insurance, or no insurance that would pay anything to you until you have, at least, sold your house to pay the under-the-deductible expenses. Within 3 or 4 years many fewer Americans will have insurance than before reforms started. So, what is the solution?

Of course! Mexico! We have doctors, hospitals, pharmacies, etc., etc. that are much, much cheaper. Personally I will be screwed: the prices will skyrocket, so I will be forced to start using much more the public healthcare (like most Mexicans I am eligible, but, having the money to do so, I tend to use the conveniences of the private sector). But for many Americans this will become the main way to access decent healthcare. If you need to program a surgery, you will fly to Monterrey. Buy antibiotics? Tijuana, of course! Childbirth? Mexico City is waiting!

The Angeles Group will build dozens of new hospitals all along the Texas border. Hospital Angeles Puerto Peñasco will be located right next to the new Camino Real Mar de Cortés - so that while a Phoenix resident has his heart surgery his wife can spend a few nice days on the beach. After a while, American kids, locked out of US medical schools (these will reduce the intake, to avoid increased competition in the sharply reduced medical services market), will start applying to Universidad La Salle and other private Mexican schools, so that, upon graduation, they would be able to work in the south-of-the-border hospitals, specializing in care of uninsured Americans. True, the sallaries will be lower: but they will still be high by Mexican standards, and the price of medical education will be a fraction of what it is in the US (and, of course, you can start earning money much earlier: medical degree takes five years after high school, and there is nothing like the ordeal of the American medical residency).

But, of course, with the major expansion of the anglophone US-oriented medical industry in Mexico, this will become very attractive. Insurance companies will start offering to pay for trips to Mexico. In fact, new Mexico-based insurers will emerge, offering insurance for Americans conditional on them traveling to Mexico. These will be much cheaper than traditional insurance policies - so major employers will start offering these packages, rather than those provided by US-based insurers.

So, in 2032 the newly-elected President Shrump will announce a major crack down on the outsourcing of US medical services to Mexico...
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Mr. Morden
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« Reply #21 on: January 14, 2017, 12:45:17 AM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.

But do they really think defunding the law will make people think it's the Democrats fault for the ACA's failure?

No, that's what I'm saying.  I think it's quite possible that they *don't* simply de-fund it.  They try to pass a simultaneous repeal-and-replace, but it doesn't pass because they don't have the votes for it.  And then they're just stuck and move on to other issues.  I mean, if it was actually a high priority issue for Trump, then they'd try to press ahead with it.  But since it's clear that he doesn't care, then I think "nothing passes and Obamacare survives" is a very real possibility.
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justfollowingtheelections
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« Reply #22 on: January 14, 2017, 01:21:34 AM »

I don't mean to be trolling here, but again, there is a plan already in place that seems to work well, and it's called Medicare. Just expand it to include everyone.


Exactly.
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Tintrlvr
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« Reply #23 on: January 14, 2017, 01:45:46 AM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.

But do they really think defunding the law will make people think it's the Democrats fault for the ACA's failure?

No, that's what I'm saying.  I think it's quite possible that they *don't* simply de-fund it.  They try to pass a simultaneous repeal-and-replace, but it doesn't pass because they don't have the votes for it.  And then they're just stuck and move on to other issues.  I mean, if it was actually a high priority issue for Trump, then they'd try to press ahead with it.  But since it's clear that he doesn't care, then I think "nothing passes and Obamacare survives" is a very real possibility.


I don't think Trump cares about anything, really. The point is more whether Paul Ryan and Mitch McConnell care. They're the ones running the country for at least the next two years, after all. Though I agree that both would rather just let Obamacare stand and say "Well, we tried" than actually change anything, which makes the Obamacare-survives hypothetical very possible.
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Mr. Morden
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« Reply #24 on: January 14, 2017, 02:29:52 AM »

I was half-joking. You're right that it probably wouldn't pass.

But politically, it's the only way I can see them possibly both technically keeping their promise and not causing themselves a catastrophe.

I think it's quite possible that no plan is actually able to pass in the end, and so current law remains intact.  Remember that while they can defund the current law with 50 votes in the Senate plus a majority in the House, they can't actually change insurance regulations without being subject to a Democratic filibuster, and good luck with that.

So Trump and others insist on it being "repeal and replace" rather than just "repeal and nothing", but they can't actually get the votes to pass their "replace" option, so nothing passes, and Trump tries to blame the Dems for thwarting his election promise.

But do they really think defunding the law will make people think it's the Democrats fault for the ACA's failure?

No, that's what I'm saying.  I think it's quite possible that they *don't* simply de-fund it.  They try to pass a simultaneous repeal-and-replace, but it doesn't pass because they don't have the votes for it.  And then they're just stuck and move on to other issues.  I mean, if it was actually a high priority issue for Trump, then they'd try to press ahead with it.  But since it's clear that he doesn't care, then I think "nothing passes and Obamacare survives" is a very real possibility.


I don't think Trump cares about anything, really. The point is more whether Paul Ryan and Mitch McConnell care. They're the ones running the country for at least the next two years, after all.

What I mean is that if Trump actually exerted presidential leadership to insist to the GOP caucus in Congress to make something happen, then they could try to come up with some creative solutions here.  Something that could be done via reconciliation, and get enough GOP votes to pass.  He could potentially use the bully pulpit to press the issue, working alongside McConnell and Ryan, a la Obama's presidential leadership working with Pelosi and Reid, which got Obamacare passed in the first place.

But McConnell and Ryan aren't powerful enough to do that on their own.  There'll be enough members who won't listen to them that I'm guessing nothing gets done.
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