He’s got a point: “Don’t piss on my neck and tell me it’s rainin’….” Yes, I know President Trump is working against the GOP sponsored Ryan ‘Obamacare Lite,’ however, so long as Ryan is left in his position, Quisling that he is, the ACA “Obamination” will be left in place.
Dear President Trump: The Congress, including the Speaker of the House, needs to be drained. The full faith and credit of those who elected you is at stake.
So it’s out….. well, at least sort-of-out.
And let me point out a few things about this bill, at least as far as I can determine from reading and cross-referencing it:
- It does not repeal the “penalty.” It instead moves it to the back end; if you don’t have insurance (by choice) and then buy it, you get hammered with a 30% penalty for a year. For most people that’s far more than the ACA penalty for not having insurance — it could easily be $3,000 or more! This is outright fraud on the part of the GOP which said it was repealing the penalty. Paul Ryan, Donald Trump and the rest are all ****ing liars.
- Medicaid expansion is essentially ended and cost-pickup for the states is capped to CPI-U’s medical expenditures inflation index on a forward basis. This will detonate State budgets within about 10 years as the current spend is expanding at ~9% a year but the CPI-U index is less than half that.
- It does not repeal the prohibition on discrimination in price (or denial) for pre-existing conditions, but it does increase the multiplier for age to 5 (from 3.)
- IT IS NOT A REPEAL OF THE ACA — not even close. The vast majority of the ACA remains intact. The “mandate” is gone but the penalty remains, just shifted to the back side and for many will be far worse than the penalty would have been. The restriction on what plans you can sell is gone, subsidies are cut, indexed only to age and paid to HSAs instead of directly to insurers. It does repeal many of the “add-on” taxes that paid for the program previously as well.
Repeal and replace? More like bend over, grab your ankles and bite down on a big stick so you don’t chomp your tongue off.
When it comes to the media and their “lead-in” to the bill you have pieces like this, which sound awfully good when you read them until you realize there’s exactly zero being said about the how.
Remember, it’s who, what, when, where, why and how (sometimes stated as “with what?”)
These are the 5 Ws (and one H, or sometimes 6 Ws) that form the basis of journalism.
Where’s the examination of that last one: How?
Not in that oped and not in the “new bill” either IN WHICH THERE IS NOT ONE WORD ABOUT ANTI-TRUST, COLLUSION, OR ANY OF THE OTHER PRACTICES THAT MAKE MEDICAL CARE SO DAMNED EXPENSIVE, NEVER MIND THAT MANY OF THESE PRACTICES AND COLLUSIVE ACTS WERE RULED ILLEGAL IN 1979 BY THE SUPREME COURT YET THOSE LAWS ARE NOT ENFORCED AND THE COLLUDING PARTIES ARE NOT INDICTED, PROSECUTED OR BROKEN UP.
As an example you have laments like this from a physician:
Republicans ran on a platform of repealing and replacing a failing ObamaCare system.
Democrats touted ObamaCare as an overwhelming success. Neither party has really addressed the issues surrounding the law—patients are experiencing higher costs, diminished access and poorer quality care.
I have seen my patients go without medicines, miss important preventative care milestones and struggle to find access to high quality care. Copayments continue to increase—deductibles are rising (more than $12,000 in some cases) to the point where an average family simply cannot utilize insurance except in catastrophic circumstances.
There’s a hell of a screed in that article but as I read it what kept going through my head is that this is a physician who’s complaining that Washington has failed to fix this and that, lawmakers are putting “their own interests” ahead of the public and so on. Complaint after complaint after complaint leveled against both political parties.
But nowhere in that article is found any discussion about the how — that is, how is this individual physician prevented from putting a stop to that crap for his customers right damn now!
In other words how is it that he can’t charge $100/hour (a quite-reasonable wage, all things considered — that would be $200,000 for 50, 5-day-a-week 40 hour weeks of work in a year with 2 weeks off) in cash for his patients and given that most patients actually see said doctor for about 15 to 30 minutes per visit you then get to explain why someone who has a $12,000 deductible shouldn’t just pay $50 for 30 minutes of said doctor’s time with said physician seeing said person under his terms (and none of the nonsense being complained about.)
Is the problem that you can’t just pay the $50 because said doctor has been prohibited from holding out his hand for you to stuff a Grant into it? What law prevents him from doing that? Why is that all of these “escalating costs” and “administrators” have resulted in actual physicians kneeling before Zod instead of them telling everyone trying to mandate that crap to stick it up their ass?
In short did someone make the current model something he’s forced into rather than chooses and if so who did it with what law(s) (specifically) and why is doing so legal especially when every doctor in a given area has the same “problem”? If there’s no competition due to collusive behavior in a place where competition would obviously make someone richer at the other competitor’s expense then you have a very solid case that a felony violation of the law is taking place among all those who are doing the colluding! If extortion (that is, some sort of threat) is involved then it’s even worse. I remind you that in 1979 insurance companies and pharmacies tried to claim that their collusion was exempt from anti-trust law and lost at the Supreme Court.
There are only two possibilities: This physician is part of the scam voluntarily or he is being forced involuntarily. He’s either a protagonist and thus willingly engaged in the offense or he’s a victim of it.
Which is it and why isn’t that the center of the a whole lot of journalistic attention?
You know…. the old “How” question that is supposed to be central to journalism?
Start asking that question and you will find yourself in two places at once. The first is here, where we can remove $400 billion a year from the federal budget alone by cutting the crap on just one disease — by putting sufferers of same first and prescribing health instead of expensive drugs that do not resolve anything. The second is found in making The Surgery Center of Oklahoma the model for all medical practice exactly as it is for a car repair shop; that is, mandatory posting of prices and charging of the same price for the same product or service to all who come in the door for same.
Neither Democrat or Republican members of Congress will do either, and neither will Trump — and journalists will not poke at why physicians have not revolted en-masse and destroyed this demonic system from within by simply putting out their hand and demanding a Grant to see them for 30 minutes of their time, ending the rampjob on the front end, at the local medical office, with finality while demonstrating that obtaining medical advice need not bankrupt you or be complicated.
As a result of all these actors serving those who are colluding to jack up the price by a factor of five to ten over what it should be for medical care in this country and the complete unwillingness of both Congress and the press to call those parties out and put a stop to it the federal budget is on a path to implosion along with all of the pension systems in the United States within the current President’s term.
In 2009 I gave you a fairly simple “how” in these very pages, and have followed through with far more since, including more-complex ideas, all centered on the rule of law — specifically, law that has existed for more than 100 years and does apply to health care.
You might want to go back and read that piece again. Then read this one.
Make sure you note the dates on both….
As for Trump, Price and the GOP?