Can Obamacare Be Saved?

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Health Care

The Republican plan, as I understand it, is to pass a law repealing Obamacare as soon as the next Congress is called into session. However, sniveling weasels that Republicans are, the law won’t go into immediate effect. They’ll put the end date sometime after the 2018 midterms, of course.

The latest is that Republicans will repeal Obamacare right away in January using a process called budget reconciliation, which lets them repeal budgetary items with just 51 votes in the Senate. Then, Republicans will enact a self-imposed deadline roughly three years from now before they have to pass a replacement plan. How much of the existing Obamacare elements will limp along until then remains unclear, and whether you can repeal some but not all of Obamacare without causing it to collapse is a big open question.

But such a scenario also creates a self-imposed crisis that Republicans hope will pressure Democrats into coming to the negotiating table down the road. This is where clarity is crucial. Three years from now, it’s not the Democrats’ crisis. It’s a Republican one. There is no health care cliff, Obamacare doomsday, congressional-health-care-death-spiral apocalypse unless Republicans create one by repealing Obamacare without a replacement plan.

And they’ve never been able to come up with a replacement plan. Time and time again they claim to have done so, but that plan always falls apart under scrutiny, forcing them to come up with another replacement plan.

The biggest bite to any Republican so-called plan always is that they can’t cover people with pre-existing conditions without either a mandate for everyone to buy insurance (which, of course, in their minds is Evil) or without putting uninsurable people into high-risk pools, which have been tried in several states and just plain don’t work.

And if they eliminate the mandate but keep the pre-existing condition requirement, the costs of policies would more than skyrocket. It would set the health insurance industry into chaos. See “Why Keeping Only the Popular Parts of Obamacare Won’t Work.”

But the real bite is that the guy Trump wants to head Health and Human Services is a five-alarm whackjob. In his perfect world, only young, healthy people (and the very rich) would have insurance and the rest of us would just be required to suffer and die.

Rep. Tom Price (R-GA), President-elect Donald Trump’s pick for health and human services secretary, already has a plan for how to abolish Obamacare. …

…Price will arrive at HHS with a clear blueprint for what comes next. He is the author of the Empowering Patients First Act, one of the most thorough and detailed proposals to repeal and replace Obamacare. …

… It would replace the law with a plan that does more to benefit the young, healthy, and rich — and disadvantages the sick, old, and poor. Price’s plan provides significantly less help to those with preexisting conditions than other Republican proposals, particularly the replacement plan offered by House Speaker Paul Ryan (R-WI).

The biggest cut to the poor in Price’s plan is the full repeal of the Medicaid expansion, a program that currently covers millions of low-income Americans, which Price replaces with, well, nothing.

I caught a few seconds of Paul Ryan’s interview on 60 Minutes yesterday, before I was able to change the channel. Ryan assured America that Obamacare would be replaced by “Patient-centered healthcare that gets everybody access to affordable healthcare coverage, so that they can buy whatever they want to buy.” And I want a pony, too.

But now the Republicans will have to put up or shut up, and they can’t do it. Whatever they do is going to hurt a lot of people.

So they’ll make a big show out of repealing Obamacare, except most likely it will still be in effect — mandate and all — for the next three years or so. But it’s possible enough of the whackjobs — like Tom Price — will insist on taking it apart sooner, which will cause widespread disaster and lots of suffering.

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17 Comments

17 Comments

  1. c u n d gulag  •  Dec 5, 2016 @8:02 pm

    “…widespread disaster and lots of suffering…”
    AKA in conervative terms:
    Governance, and fun!

    Hey GOP, we all know that you’re all vicious MFers, FFers, and f*ckers of all and any who weren’t born or became rich!
    But please, don’t make us all go through your torturous 3-year long foreplay – just f*ck us good and hard, and then go on to f*ck others, and leave all of us to reclaim what’s left of our lives and dignity after you’ve done satisfying yourselves.
    I know with your small hands and genitals, you’ll have to use degrading violence and intimidation to acheive your satisfaction, but this time, please make it quick.

    I’ll be 59 soon, and can’t take much more of your blatant fear and hatred, of “We the people…”

    See you in the GULag soon, folks!

  2. Tom_b  •  Dec 5, 2016 @8:17 pm

    You might ask yourself, “Why not simply repeal Obamacare and replace it with something exactly the same, but called ‘Ryan-care’?” Very simple; because Obamacare, sadly, puts some meager limits on the ability of private health insurers to fleece their subscribers.

  3. KC  •  Dec 5, 2016 @8:30 pm

    The good news is I don’t see Democrats jumping up to help the Republicans. If they pass something with a termination point Dems need to let Republicans answer for the disaster. From what I’ve read, the termination-down-the-road strategy itself could create trouble in the insurance market.

    If a crazy guy stops along side of you, threatens to drive off a cliff, and asks you to hold the wheel, most people would just keep waking. If the Dems stay unified and keep on walking, I don’t see how the Republicans come away unscathed.

  4. Tom_b  •  Dec 5, 2016 @8:43 pm

    ” If the Dems stay unified and keep on walking”

    Seen a lot of pigs flying? Better get my raincoat.

    But, yes, unified dissent would be a fine plan.

  5. KC  •  Dec 5, 2016 @10:01 pm

    Tom_b, there’s not a Lieberman in the Senate caucus whose only mission is to get on television and piss on his colleagues, at least as far as I see yet. Maybe one will appear. Maybe the Republicans are going to find success in messaging “we are going to fuck things up in the future and it’ll be your fault for not helping us do it now,” but it’s a long shot I think. I mean, there are great marketing folks out there, but even some Trump voters on the Medicaid expansion in Kentucky are going to know which party is taking stuff from them,

  6. csm  •  Dec 5, 2016 @10:09 pm

    The repeal and wait strategy is dependent on democrats chickening out at some point prior to the repeal date and caving in. And given their history of being scared stupid by the GOP, unfortunately, its not a bad bet to make.

    What dems should start doing now is what the GOP did in the run up to Obamacare implementation, and start holding town hall meetings, and educate the pubic in simple terms, on what the GOP is planning to do, and what things like “premium support” means, what Medicare privatization will mean, etc. And do it without the wonkishness they are so prone to get down into.

  7. maha  •  Dec 5, 2016 @10:43 pm

    csm — “What dems should start doing now is what the GOP did in the run up to Obamacare implementation, and start holding town hall meetings, and educate the pubic in simple terms, on what the GOP is planning to do, and what things like “premium support” means, what Medicare privatization will mean, etc. And do it without the wonkishness they are so prone to get down into.” Amen, bro.

  8. goatherd  •  Dec 6, 2016 @8:19 am

    This article might seem tangential, but, I don’t think it is. I seem to have lost my faith in the ability of people to think their way out. The implements of persuasion have become pervasive and horribly effective, while our minds have remained only an update above that of a chimpanzee.

    http://www.monbiot.com/2016/12/01/the-misinformation-machine/

  9. bernie  •  Dec 6, 2016 @8:34 am

    Oh gulag, your window to and vision of the world is clear and honest.  Reality in the world of the Cheeto Messiah will be harsh, Exploitation of the those who are ill or suffering will be rampant.  Many will be casualties.  Most will climb mountains of medical bills and drug costs that will ensure they and their loved ones will be permanent wage slaves.  It must just make these elitist clowns giddy in the havoc they will wreak.  Antisocial medicine will be the new standard in the healing arts. 

    When the cover of the AARP Bulletin has a subtitle of : How to make the health system work for you, we are in trouble.  The eight page pull out section suggests much advice appears needed.  Rule number one is always Thou shall remain healthy. Rule number two is never elect crazy people to government positions of power.  If you or your fellow countrymen break both of these rules, panic.

  10. elkern  •  Dec 6, 2016 @11:53 am

    Yes, what CSM said!

    But the Insurance industry is likely to squeeze some Dems toward “compromise”. CT is a pretty Blue state, but lotsa big Insurance companies have HQ here. My own Rep co-signed the bill last year to repeal the Cadilac Tax.

  11. c u n d gulag  •  Dec 6, 2016 @12:25 pm

    I hope that by the New Year, I can shake my PTETSD – Post-Trump Election Traumatic Stress Disorder – and hop back into some form of activism against the looming Category 7 shit-nado on the horizon.

  12. Swami  •  Dec 6, 2016 @12:57 pm

    gulag ..I’m suffering from the same ailment..I keep having recurring visions of Trump standing at a lectern before an audience of rabid admirers and screaming like a crazed mobster..“Get him out of here! In the old days he’d be carried out on a stretcher.”
    I’m numbed by that vision. All I can think to say is.. Oh, my God! What a fucking horror!

  13. Bill  •  Dec 6, 2016 @2:02 pm

    I remember when the response to Monbiot was for righties to call anybody who thought like that “moonbats”. People who puzzled over the roles and competencies of a government for the people were called “loony liberals”. Republicans were masculine, self-reliant and strong. Democrats were feminine, gay and undocumented. Etc…

    For mass persuasion purposes, I don’t think there’s anything wrong with wonkishness. But I think it needs to hang out in the background like Luca Brasi. Put the simple truths up front.

    Of course dealing with those too far gone is best left to specialists in cult deprogramming. Minds well-exercised to use ‘facts’ to support beliefs they’ve already decided on (instead of using facts to help them decide what to believe as seems normal), are pretty hard to change.

    Mylan’s Epipen scandal a few months back, I recall an online discussion with a nuisance wingnut calling for the elimination of the FDA because we all generally agreed it was now corporate/government corrupt/broken. Finally one guy showed up and said simply: “And we’ll have you test out all the new drugs.” The wingnut disappeared. Simplicity works.

  14. LongHairedWeirdo  •  Dec 6, 2016 @2:03 pm

    Ryan’s statement is a perfect example of the problem of stenographic journalism. Of *course* he says the Republican plan will be good. But no one is willing to be “partisan” to point out *there is no plan*.

    The big, big, big centerpiece to their plan is to strip away any protections your state gives to health insurance consumers. Your state forces insurers to cover all AIDS drugs? Who cares? Your state forces insurers to cover diabetic testing supplies and at least one of every major category of drug for managing blood sugar? Who cares? Your state demands at least 6 weeks of followup care after a heart attack? Who cares, that’e *expensive* send them home with a few pamphlets – in English, naturally, translation services cost money!

    No, they’ll let one state set the standard for health insurance, and that will be the state with the maximum H&B ratio possible – and whichever state that is, suddenly every health insurer in the nation will have an office there, and be selling products under that state’s regulations.

    (H&B you ask? “Hookers and Blow” for the office parties. You can only spend so much of the profits on such things, unless it’s literally raining money into your swimming pools.)

  15. paradoctor  •  Dec 6, 2016 @5:02 pm

    How to predict ‘conservatism’: it always chooses the more destructive option. Whatever injures, ruins or kills more; that will be called conservative. This is, of course, straight-up doublethink. War is peace, slavery is freedom, destruction conserves.

    Why this perversity? Why don’t conservatives conserve? Is the very name a Big Lie?

    And why don’t liberals liberate? Why don’t libertarians liberate? And why don’t progressives progress?

    I suppose it has to do with the corruption of power, the limits of language, and the inherent dynamism of the world. Is there a Buddhist perspective on this, maha?

  16. paradoctor  •  Dec 6, 2016 @5:24 pm

    I propose these corrections to the misnomers conservative, liberal, libertarian and progressive: respectively destructivist, regulator, propertarian, and retreatist.

  17. csm  •  Dec 7, 2016 @12:07 am

    I don’t see how what the republicans say they want to do will benefit the health insurance industry. Already today, the “Freedom Caucus” in the house is revolting against the “repeal and delay” approach being floated by leadership. They want to vindictively repeal and replace, root and branch immediately. Not only do they not care about throwing 20 million people off health insurance, they don’t want to be denied the hateful pleasure of doing so. And these are 20 million fewer customers the health insurance industry will immediately lose, most of whom won’t be able to afford to come back. Not to mention the cost to the health insurers of modifying their policies and reprogramming their systems to support the change.

    Here’s an idea of what we’re facing. I recently shopped around for an independent insurance policy, a PPO for myself and the Mrs, in the event I were to take a contract job as a W2 hourly “employee” I was considering, where I’d have to provide my own benefits, particularly health insurance. The monthly premium I would pay for the higher deductible, higher copay plan is $1,479.84 for the two of us. The monthly premium cost for the “Cadillac” is $1,786.46! And these premium rates will likely increase after the GOP gets done with the ACA, as health insurers will look to pass on/recoup their losses and costs on to existing customers. More employers are offering health savings accounts as a health benefit to employees, and can you blame them, given the high cost of health insurance?

    Most people who work for a living can’t afford private health insurance and these rates. No wonder young people decide to go without. They get shamed as immature and irresponsible for not having health insurance, but for what many of them are getting paid, how can anyone expect them to be able to afford it? And imagine a senior on Ryan’s “premium support” plan trying to buy a policy on the private market with a “premium support” check. And imagine doing it as a 60 something without the pre-existing conditions clause some on the right want to eliminate.

    The democrats don’t even need balls for this one. Brains aren’t required either; this is a no effing brainer! Let the GOP do repeal and replace/delay. Tell Ryan to “please proceed” with his premium support, but let them know they’ll be doing it with zero dem support. The “Freedom Caucus” might get their pound of flesh, but the chunk this will take out of their behinds will be huge IF the democrats respond and do what should be obvious



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