straightUp Loc: California

We've also had a single-payer system for our vets since the end of WW1.

And good point about rising costs, which were indeed rising at rate of about 6% prior to the ACA. Since the ACA was installed, that rate dropped by half. To be fair, it should be noted that the sluggish economy, the expiration of several pharmaceutical patents and a one-time reduction in Medicare payment levels to skilled nursing facilities all contribute to the decrease but nevertheless, the cost of healthcare is now lower than it's been in 50 years. So trying to insist that the ACA is responsible for increases in the cost healthcare is pretty far fetched.

I do understand that on a state by state level, the effects of the ACA are different. In states like California and New York the ACA is working really well, where in states like Kentucky it's not. The reason for this is that in states like CA and NY the government isn't afraid to regulate the markets with anti-trust laws that prevent monopolization. The result is a vibrant market with lots of competing providers. In red states there is more monopoly and less choice. The ACA, being a market-based solution relies on the conditions of the market.

My advice to those living in rural red states is to stop blaming the ACA and start actually trying to fix the problem by encouraging your government to interfere with the monopolization of the healthcare market.

Docadhoc Loc: Elsewhere

Stop making a fool of yourself over things you have no knowledge of.

I was on of the original team of Drs. asked to review the ACA and report our findings before you ever heard of it. We unanimously found that it was self destructive and pointed out the flaws. What we predicted has come to pass and ultimately it will die.

The logic behind it was flawed. We were thanked for our input and summarily ignored. Today as this mess dies, you see the errors they made. We conclusively agreed it was designed to fail. And it has. It was nothing more than a stepping stone to a government run one payer system.

You.know nothing of this ACT other than what your leaders tell you. You have a habit of shooting off your mouth regarding things you have no clue about and regarding this act you are out of your league.

The plan is failing and the rate of failure is accelerating. Only the blind and progressives can't see it. The blind have an excuse.

No matter what you think or want, Obamacare is going to expire. If the right is a group of terrible people as you say, they will allow it to fail, blame the left as they should, and let you go without coverage for a time.

If you wish to continue coverage I suggest you contact your reps and encourage them to work with the right to develope a functional plan before it's too late.

Or you can continue to shoot off your mouth and continue.making an idiot of yourself.

Docadhoc Loc: Elsewhere

I didn't promise to repeal or replace anything. I was asked to review and tender my opinion. I did. And I told them that their logic was flawed and it was.

You are so ignorant about this that you think the rising costs of the day we're germaine. THEY WERE NOT.

The STRUCTURE was flawed. It GUARENTEED the act would fail.

You are so ignorantly shallow you have no idea how to.even think. The cost of the day was meaningless. The plan structure GUARENTEED people would refuse to buy, and more would drop out, then insurance carriers would quit, etc, etc.

Just because you are too dumb to understand how to take a complicated plan apart piece by piece and find the flaws doesn't mean others are as stupid as you.

Grow up. There are many things in life far above your ability to comprehend. This is one of them and probably why you weren't asked for your input.

Those who had a lifetime in the field and were considered experts were the ones asked.

Stupid democrats. They should have asked you.

And who told you that anyone from the not left is hanging their head in defeat? Nothing was lost. Once again you show your lack of common sense. Any way you cut it, you lost.

JFlorio Loc: Seminole Florida

You are describing an inter-net troll Doc.

straightUp Loc: California

Wow... it's not often that a post reveals so much about it's author. First of all, I don't know what kind of doctor you're pretending to be but the ACA wasn't rolled out to a panel of doctors before anyone else knew anything about it. You make it sound like the ACA came out of some secret laboratory. It didn't. It evolved... in public. It took ideas from other plans, mostly Republican, that have been publicly debated for years. In fact the ACA is largely based on Mitt Romney's plan which was actually implemented in MA when he was still governor of that state.

I've been paying attention to healthcare reform since Bill Clinton was in office and I was helping with the development of the EMR system (Electronic Medical Record) at Kaiser Permanente in compliance with the laws Clinton was pushing for back then. I watched his wife in Senate fighting for reform during the Bush Administration and getting shut down by Republicans that didn't want reform to be handled by Democrats. I read about the options suggested by members of both parties across two administrations (Dean, Edwards, Clinton, Romney, Gingrich...) and when Obama came to town, I watched him put these ideas together and push for a law. I watched the resulting bill getting flipped back and forth between the chambers and between the parties inside the chambers for a little more than a year and I read the adjustments and amendments as they happened, as slowly it became what it is now. It was NEVER a secret.

Apparently, some of people think that the ACA was sprung on us. I see them on this site and elsewhere insisting that the Democrats pushed the bill without even giving the Republicans a chance to review it, but anyone who has been monitoring the activity knows that's a blatant lie and the only people that buy it are those who just weren't paying attention. Not everyone was so oblivious "doc" and from the perspective of someone who has been closely watching the entire process... well, you can imagine what your "I'm a doctor who reviewed the plan before anyone knew about it" says to us.

If I'm wrong, then by all means do share your prognosis. How exactly (from a doctors standpoint) is a market-based economic plan like the ACA "self-destructive"? Exactly, where is the "logic flawed"? I'm sure you still have all your notes from when you were on the panel, right?

buffalo Loc: Texas

Simple..."Exactly" how is a mandate a market based economic plan? I was in the used car business and would have loved for Congress and obammy to have passed a mandate that everyone must buy a used car from me in my area. What hurt my business more than all the stupid regulations was the "Cash for Clunkers" government bullshit. It took many GOOD used cares off the market and drove the price of them up to the point that poor and credit challenged people could not afford them. Not every one can buy one of the sorry overpriced new pieces of shit, the same with over priced piece of shit policies from private, for profit health INSURANCE corporations.

My MEDICAL DOCTOR brother said from the onset that the ACA was going to fail. But moonbatty bitch pelosi said we had to pass it before we could find out what is in it. So, your being disingenous to say the least, straightup!

Both the ACA and the AHCA were/are pieces of shit.

JFlorio Loc: Seminole Florida

You're not going to get anywhere conversing with the self recognized most interesting man in the world.

buffalo Loc: Texas

Yes, bro and I were talking about health CARE (I get a lot of my opinions and ideas from him, I'll admit) the other day. He said you cannot argue with a dishonest person.

CounterRevolutionary

Straightup, I disagree with these statistics. The real cost in healthcare is not medicine, it is the OVERHEAD of this monstrous bureaucracy of middlemen between the patient and his doctor.

CounterRevolutionary

Florio, take a look at these two articles on why Ryancare failed; it looks as Speaker Ryan sabotaged his own party:

Mike Lee's Obamacare Bombshell
by Ramesh Ponnuru, March 32, 2017
http://www.nationalreview.com/corner/446032/mike-lees-obamacare-bombshell

"Sen. Mike Lee, R-Utah, said on Wednesday that the Senate parliamentarian has told him that it may be possible for Republicans to push harder on repealing Obamacare's regulations than the current House bill, which contradicts the assertion by House leadership that the legislation goes after Obamacare as aggressively as possible under Senate rules...

Lee also said that the parliamentarian told him it wasn't until very recently, after the unveiling of the House bill, that any Republican even asked her about the possibility of repealing regulations with a simple majority...

The central defect of the bill is that it leaves too many Obamacare regulations in place. That's why conservatives rightly say that it falls short of repealing and replacing Obamacare. It's why it doesn't do much to lower premiums. If it did more to reduce those premiums, it would make coverage more attractive to people and more people would get covered. Even the Congressional Budget Office, as dubious as some of its assumptions are, acknowledges this point..."


Interview with Senator Mike Lee of Utah.
Senate Parliamentarian Seems Open to Robust Obamacare Repeal
by Deroy Murdock March 23, 2017
http://www.nationalreview.com/article/446034/obamacare-repeal-senate-parliamentarian-rules-allow-house-republicans

In other words, Senate Parliamentarian Elizabeth McDonough said it is completely possible to craft a Repeal & Replace Obamacare bill that takes out all Obamacare regulations plus the Obamacare taxes, and Speaker Paul Ryan's 3 step approach is unnecessary. But nobody from the House even approached her on what the parliamentarian rules of the Senate were regarding this filibuster-proof passage possibility until a day before the vote.

What did the big pow-wow between Trump and the Insurance companies discuss to stall the passage of healthcare reform?

buffalo Loc: Texas

Exactly and anyone who argues otherwise is being dishonest.

http://www1.salary.com/UNITEDHEALTH-GROUP-INC-Executive-Salaries.html

JFlorio Loc: Seminole Florida

Would not be surprised at all. Ryan is a big government globalist.

CounterRevolutionary

Buffalo, the salaries of the CEOs to run a corporation with 20,000 employees must reflect their responsibility.
Why does it take 20,000 employees to calculate the cost of children's "essential" glasses for $200 dollars at Walmart?

Why pay $14,000 dollars per year for Cadillac Obamacare health insurance when you could pay $1,000 annually for catastrophic health insurance purchased across state lines and open a Health Savings Account for the small stuff?

Do you know that before Obamacare, there were over 1,700 health insurance companies to choose from in America, it's just that the 1945 McCarran-Fergusson Act put them all under the restrictions of the Interstate Commerce Clause so we could not shop across all state borders.

What went down at that big conference Trump held in the Oval Office with the CEOs of those Health Insurance Companies two weeks ago?
Something is going on. Why are we stalling fixing the spiraling down crash of the insurance industry? Trump does not want the Public Option; remember he is a capitalist of the highest order.
Go figure. Is he playing hardball with the stupid politicians?

Interview with Senator Mike Lee of Utah.
Senate Parliamentarian Seems Open to Robust Obamacare Repeal
by Deroy Murdock March 23, 2017
http://www.nationalreview.com/article/446034/obamacare-repeal-senate-parliamentarian-rules-allow-house-republicans

CounterRevolutionary

That's a possibility. Speaker Ryan was very much in favor of the Trans Pacific Partnership, TPP, which Trump immediately canceled through an executive order when he took office. But Ryan's good looks, maybe his charm, is how he got elected? Oh, why do all our heroes have feet of clay?

CounterRevolutionary

Buffalo, try this:

Dr. Rand Paul’s Obamacare Replacement Act, S. 222:
https://www.paul.senate.gov/news/press/dr-rand-paul-unveils-obamacare-replacement-act

Legalizes Inexpensive Insurance Plans:
•Ensures that Americans can purchase the health insurance coverage that best fits their needs.
•Eliminates Obamacare’s essential health benefits requirement, along with other restrictive coverage and plan requirements, to once again make low-cost insurance options available to American consumers.

Protects Individuals with Pre-Existing Conditions:
•Provides a two-year open-enrollment period under which individuals with pre-existing conditions can obtain coverage.
•Restores HIPAA pre-existing conditions protections. Prior to Obamacare, HIPAA guaranteed that those in the group market could obtain continuous health coverage regardless of preexisting conditions.

Helps More People Save To Buy Health Insurance and Cover Medical Costs:
•Incentivizes savings by authorizing a tax credit (up to $5,000 per taxpayer) for individuals and families that contribute to HSAs.
•Removes the annual cap on HSAs so individuals can make unlimited contributions.
•Allows HSA funds to be used to purchase insurance, cover premiums, and more easily afford a broader range of health-related expenses, including prescription and OTC drugs, dietary supplements, nutrition and physical exercise expenses, and direct primary care, among others.

Guarantees Fair Tax Treatment of Health Insurance:
•Equalizes the tax treatment of the purchase of health insurance for individuals and employers by allowing individuals to deduct the cost of their health insurance from their income and payroll taxes.
•Frees more Americans to purchase and maintain insurance apart from their work status.
•Does not interfere with employer-provided coverage for Americans who prefer those plans.

Helps Individuals Join Together to Purchase Insurance:
•Expands Association Health Plans (AHPs) to allow small business owners and individuals to band together across state lines through their membership in a trade or professional association to purchase health coverage for their families and employees at a lower cost.
•Also allows individuals to pool together through any organization to purchase insurance.
•Widens access to the group market and spreads out the risk, enhancing the ability of individuals and small businesses to decrease costs, increase administrative efficiencies, and further protect those with pre-existing conditions.

Allows the Purchase of Insurance Across State Lines:
•Creates an interstate market that allows insurers who are licensed to sell policies in one state to offer them to residents of any other state.

Increases State Medicaid Flexibility:
•Enables states to fully exercise current flexibilities afforded to them through Medicaid waivers for creating innovative state plan designs.

Empowers Physicians:
•Allows non-economically aligned physicians to negotiate for higher quality health care for their patients.
•Amends the Internal Revenue Code to allow a physician a tax deduction equal to the amount such physician would otherwise charge for charity medical care or uncompensated care due to bad debt, limited to 10% of a physician’s gross income for the taxable year.

And it is all doable on a 51% simple majority vote in the Senate under the Budget Reconciliation Act, according to the Senate Parliamentarian Elizabeth MacDonough, who was not consulted for permission by the House Speaker Paul Ryan. Why?