ACP45 Loc: Rhode Island

Put aside for a moment the basic concept of whether or not Obamacare is good public health insurance policy.

I am curious how OPP'ers view the current disagreement between President Trump and Senator Rand Paul on the "so called" effort to repeal Obamacare know as the Graham-Cassidy Bill.

President Trump:
["Rand Paul is a friend of mine but he is such a negative force when it comes to fixing healthcare. Graham-Cassidy Bill is GREAT! Ends Ocare!"

"Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as 'the Republican who saved ObamaCare.'"
Rand Paul is a friend of mine but he is such a negative force when it comes to fixing healthcare. Graham-Cassidy Bill is GREAT! Ends Ocare!
— Donald J. Trump (@realDonaldTrump) September 20, 2017]


Senator Rand Paul:
[No one is more opposed to Obamacare than I am, and I've voted multiple times for repeal. The current bill isn't repeal.
— Senator Rand Paul (@RandPaul) September 22, 2017
Calling a bill that KEEPS most of Obamacare "repeal" doesn't make it true. That's what the swamp does. I won't be bribed or bullied.
— Senator Rand Paul (@RandPaul) September 22, 2017]

Whose position on this issue is more credible on this issue, when the Republican position for the past 8 years has been - Repeal- Repeal, and the party has had numerous votes (when they knew they did not count) for repeal.

Do you feel that making a "cosmetic" change to Obamacare, and then simply calling it repeal is valid, or an insult to the intelligence of the American Public?

Airforceone

See you have no idea the effects Graham Cassidy will have no GD clue what so ever. I can tell you're typical Trump supporter talk and never read the bill or its effect on 31 million people not to mention it's effect on elderly needing nursing care why do you think the GOP does not want it scored. It's sad

Obamacare is working fine and if it were not for all the misinformation that the Trump supporters suck up daly we would not be having these BS conversations. The ACA has a problem with the exchanges, and address the premiums from one state to the next. Don't start the BS of selling insurance across state lines because. An already do that and nobody does it.

The problem with the ACA is you never bothered to read it

Candace Grugel

Not only is ANY bill that sticks government's nose in healthcare an insult to us, I agree with Rand Paul. Repeal is the only thing that needs to be accomplished. At least that would be a step toward releasing the grip of socialism/communism that is being foisted upon us.

EL Loc: Massachusetts

Nobody did.

EL Loc: Massachusetts

The government should have NOTHING to do with healthcare. It's always more than twice the cost when the government gets involved. It's also NEVER well run.

4430 Loc: Little Egypt ** Southern Illinory

I totally agree !

nwtk2007 Loc: Texas

I've read it. It could possibly work if everyone bought into it even if they didn't need insurance or if they could do better n their own. Add to that what it did to private health insurance (doubled the cost) and it gets worse.

Bottom line, you can't cover pre-existing conditions and not expect the cost to sky rocket.

Thus, Ocare needs to be dropped and the move to single payer, modeled directly after the Canadian system, needs to begin.

Sorry, conservative OPP's. It's the future, period. Our freedom will remain.

lindajoy Loc: right here with you....

Nobody did is right, El!!!
And once again right, government needs to get out of our lives not continuously try to inch into it every damn time they feel we need them!!

Need them to get out of our lives, do their job in protecting this great Nation and actually do what they were elected on!!

This mess can't be fixed other than straight repeal.. They want to help~~ riiigghhtt..

This new repeal is BS and guess we all know grand standing..

Elections coming, not a politician out there is going to vote to remove anything from the people right now..They know it and so do we...

Bunch of sorry butt wimps the whole lot of them!!

PaulPisces Loc: San Francisco

Im unclear on what you base your claim, EL.
Even when insurance is left to the free market, the US has the highest cost of healthcare in the world.
See these comparisons pre-2010.

ACP45 Loc: Rhode Island

TD - You conveniently forgot (or ignored) the first sentence of my post - "Put aside for a moment the basic concept of whether or not Obamacare is good public health insurance policy."

I was seeking OPP'ers opinion on the controversy between Trump and Rand Paul on the supposed "repeal" of Obamacare that is called the Graham-Cassidy bill. You made an assumption that I did not read the bill, and call me a "typical Trump Supporter", whatever that means. Had you been reading any of my other posts on Trump I think it would be obvious I am not a "typical Trump Supporter". Focus on the subject at hand, and stop going off on tangents. Are you hostile by nature, or did you just get up on the wrong side of the bed this morning?

buffalo Loc: Texas

Not true EL. The government is the ONE payer that CAN control costs. Health CARE works nothing like other market transactions, there is no free market of supply and demand in health CARE. Economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn't hold true in medical CARE – not when the supplier also controls demand. In health CARE, doctors can stimulate demand because (a) health INSURNCE blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one. As a consumer, you are a bystander to the real action, which takes place between providers—hospitals, doctors, labs, drug companies, and device manufacturers—and the private and governmental entities that pay them. Those same providers are also pushing Americans into newer and more expensive treatments, even when there’s no evidence they’re any better.

When Medicare is paying the bills, prices tend to be lower. Medicare is by far the largest single source of revenue for most health CARE providers, which gives it more leverage to set prices. Private insurance companies and providers, on the other hand, bargain head-to-head over prices, often savagely.

Private, for profit health INSURANCE wants the cost of health CARE to be high. As compared to Medicare, the amount of administrative complexity associated with private, for profit health INSURANCE billing is huge and requires the providers to employ large numbers of people. Hospitals and physicians spend a huge amount of time generating information to convince private, for profit health INSURANCE companies to pay them. Patients aren’t usually aware that more than half of the time doctors or nurses spend at work is used to document what they do, for billing, and of course, to cover their asses. These days it is primarily on a computer. The majority of it is to prove to private, for profit health INSURANCE companies that they did what they were supposed to do. There are also many employees hospitals or a clinic who are employed primarily to communicate with private, for profit health INSURANCE companies in order to be paid. I’ve heard it estimated that 50 percent of human hours in a hospital is devoted to billing. For proof of this look how full a hospital's employee parking lot is during the week and how empty it is on weekends.

Canada and France, both of whom have systems that provide health care for every citizen at a cost that is far lower than that in the US, use single payers. This makes billing incredibly simple and actually possible for a doctor to do him or herself quickly and without help. A single payer system could negotiate with providers of health CARE services, setting prices and examining new technology based on its costs and benefits. Transitioning to a Medicare for All sytem is the only answer to controlling skyrocketing health CARE costs and providing every US citizen with quality health CARE at an affordable cost.

ACP45 Loc: Rhode Island

Buffalo,
Let me comment on one of your points:
The government is the ONE payer that CAN control costs. Health CARE works nothing like other market transactions, there is no free market of supply and demand in health CARE.
Why should Health Care work any differently than any other aspect of the free market. You say there is no free market of supply and demand. While that may be true to a large degree by the way our current health care system works, it doesn't mean that we can't reform the system to allow the free market to work the way it should.

For example, I will refer you to the reforms that both Rand Paul and Karl Denninger have proposed. (https://market-ticker.org/akcs-www?post=231949 and https://www.paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf )

While a point by point explanation would be too lengthly in this post, I will try to summarize their general thinking. Paul want to greatly expand the use of HSA's in the amount of $5,000 each year which would treated as a refundable tax credit. Unused HSA funds can be accumulated over time to cover larger expenses. You can also use the HSA account to pay your insurance premium which would greatly assist young people who would choose to purchase catastrophic policies which would be very inexpensive. Denninger has a number of proposals which would require all health care providers to post prices for their services. The whole idea is to get consumers the information they need to make intelligent pricing decisions.

The basic concept of both proposals is to lessen the strangle hold that insurance companies how have on the consumer, and their negotiated deals with the health care providers. It is unconscionable that a doctor may charge someone without insurance 10 times the amount that he has negotiated to accept from an insurance company. If a doctor discloses his fee for cataract surgery, the consumer can choose which doctor they want to use based upon price and doctor reputation. If the doctor knows he will be paid in cash immediately by the consumer, he will not have to employ a staff of people filling out insurance forms and government regulations, and will not have to wait months for insurance company reimbursement. Do you not see how that cost savings, plus marketplace competition will result in reduced costs to the consumer?

Also, consider how the government allows pharmaceutical companies to charge US citizens higher prices than the same drugs are sold to other countries at much lower costs. The most recent attempt to allow US Citizens to purchase their drugs from Canada was voted down by Congress (Thank you Senator Corey Booker for your concern that the same drugs purchased from Canada are too risky because the Canadian equivalent of our FDA is not up to the task of making good decisions - http://www.rollcall.com/news/politics/pharma-booker-canada)

I'm not saying that these few ideas are the entire answer to all our healthcare problems. But they are a good starting point. The problem is that the entrenched bureaucracy has too much invested in the current paradigm. Doctors, Hospitals, Medical Equipment providers, Insurance Companies, Pharmaceutical companies, and most importantly, our corrupt government officials who rely on campaign contributions don't want you to consider these alternatives.

Wake up people. There are better options out there than to a fricking government option. We all know that EVERYTHING government touches is more costly, and less efficient than a rational market based approach. Hold their damn feet to the fire and make them responsive to your needs.

buffalo Loc: Texas

The US health CARE system rewards quantity over quality. As I said, economics 101 teaches that as supply goes up, costs should come down. But this tenant doesn't hold true in medical care – not when the supplier also controls demand. In health CARE, doctors can stimulate demand because (a) health INSURANCE blinds most patients to the costs of services and (b) patients often don’t know whether a complex procedure is as necessary as a non-invasive one. It is the Fee For Service financial model.

Over the past 15 years, U.S. medical school enrollment has risen by 30 percent. But while the number of specialty residences – and therefore specialists in a community – has grown substantially, the number of primary care residents has remained flat.

The reason is simple: Hospitals receive the same financial reimbursement from the federal government whether they train a primary care physician or an orthopedic surgeon. The orthopedic resident will earn the hospital a lot of money while the primary care physician will bring in little or nothing. As a hospital administrator, which clinical training program would you expand? Again, it's the Fee For Service financial model.

Health INSURANCE premiums have tripled over the past decade while median employee incomes have actually fallen when inflation is taken into accounrt.. The “free” health care so many patients enjoy isn't really free. Employees have paid for the rapid rate of inflation with modest to no salary increases. They just never knew it.

Both Paul and Denninger have it wrong. A patient that can pay cash is usually charged less than those with health INSURANCE which he charges 10 times more then spends inordinate amounts of time negotiating with the INSURANCE.

So, how are the millions of working families, living paycheck to paycheck going to "SAVE" any money for anything, let alone health "CARE" or health "INSURANCE". HSAs are a tax break for only the rich. To the rest they are a cruel joke. 63% of US families have less than $500 in savings.

Government is the one "single" entity with the size and clout to control health CARE and PHARMACEUTICAL costs. Your buddies Paul and Denninger have never had to worry about getting or how to pay for health CARE.

nwtk2007 Loc: Texas

What you have described is the healthcare "monopoly." And it's just wrong.

kemmer

Since the "block grants" to the states under Graham-Cassidy will be 1/3 what the gov't. spent in 2015, and the states can decide what diseases to cover and what not to cover, both Trump's and Paul's rants are irrelevant. In any case, it appears Trumpcare 3.0 is going to fail anyway. The GOP and Democrats need to get together and just plug all the holes in ACA, and be done with it. Single payer coverage is inevitable down the line.