U.S. Congress begins its repeal of Obamacare

I can’t tell you how much dread I feel knowing that, one week from today, Donald Trump will begin his first full day as President of the United States. “President Trump”! Would any of us have not laughed at that possibility a year ago?

Well, the nightmare is about to begin. We’re going to get a young and extremely conservative Supreme Court justice to replace Scalia, ensuring a right-wing Court for years to come, and both houses of Congress are majority Republican, which all but ensures that Trump will get his agenda passed. And we have a mentally unstable president driven solely by his ego and hatred of criticism.

Now the Republicans, as promised, are beginning their repeal of “Obamacare.” Yesterday, according to The Atlantic and many other venues, the House of Representatives voted by 227-198, largely along Party lines (a few brave Republicans voted with the Democrats), to begin its repeal of the healthcare law. (The Senate voted the same way earlier in the week.) The first step was a measure called “budget reconciliation”:

What Congress approved this week was a necessary procedural step giving Republicans the power to repeal the tax and spending provisions of Obamacare, and the party demonstrated the ability to overcome some internal resistance to moving so quickly to dismantle the system enacted by President Obama and congressional Democrats.

The next step is to actually repeal Obamacare, which requires strong Republican support, and that won’t be as easy given the consequences if that law isn’t replaced by another that gives poor people some kind of healthcare. After all, over 20 million people have benefited from Obamacare, and, as House minority leader Nancy Pelosi admitted yesterday, the Democrats were far poorer at advertising their successes than at getting the bill passed in the first place.  If Republicans are simply going to take away healthcare from 20 million citizens without a replacement, they’re going to look mighty bad.

So what will their healthcare plan look like? I have no idea, but can’t imagine that it will be better than Obamacare, flawed as it was. And, although I consider myself reasonably informed on American politics—but not nearly informed as many readers here—I can’t for the life of me see any reasons why the Republicans are dismantling Obamacare save two:

1). They want to elminate an important part of Obama’s legacy, and do it as fast as possible.

2). They don’t like poor people and don’t particularly care if they have reasonably-priced access to healthcare. Their palaver about the costs of Obamacare is simply a smokescreen for their anti-poor agenda.

Some of you may poo-poo the second reason, but over the years Republicans have shown a persistent callousness toward the poor, adhering as they do to a “just world” theory that the poor deserve what they get. But as determinists we know that isn’t true: poor people are the victims of their genes and environments, not poor “choices”. This is one reason why determinism needs to be embraced by people (especially Republicans), for it breeds more empathy towards the dispossessed.

I am scared about what will happen to America within a week, and of course that will affect other nations as well. Our president will be an overgrown, emotion-ridden baby who has no idea what he’s doing; his one agenda is to puff himself up and tear down his enemies, and, I suspect, he doesn’t give a damn about what happens to America in the process.

*****

And while we’re on the topic of Trump, I refer you to reader Heather Hastie’s new post, informative as always, “Why Trump’s tax cuts probably won’t create the jobs he promises.

145 Comments

  1. Posted January 14, 2017 at 1:56 pm | Permalink

    From across the pond, Trump and his cohorts appear to be preparing for constitutional asset stripping rather than governance. My heart goes out to you.

  2. Posted January 14, 2017 at 2:01 pm | Permalink

    A small vindictive part of me is eager for them to do it. Then watch it fall apart. Especially since it will affect a lot of trump voters almost more than others.

    • Carl
      Posted January 14, 2017 at 2:20 pm | Permalink

      I can understand your feeling coming from another direction. I would like to see those who created the mess struggle with it. But not really.

      I hope the Republicans can avoid the huge mistake made by the Democrats which – aside from the actual details of the ACA – was ramming through such a large change, affecting so many people and institutions, when that change was opposed by about half the population.

      Now that the ACA is in place, I hope a solution to the now apparent problems can be had that satisfies a much higher proportion of the country. If the Republicans merely rip the existing system out, they repeat the basic mistake of the Democrats.

      • Ken Kukec
        Posted January 14, 2017 at 4:25 pm | Permalink

        … the huge mistake made by the Democrats … was ramming through such a large change …

        No, the Democrats’ mistake was in not making enough change; they should have held out for a “public option.” (Every other modern, industrialized democracy goes that one better with a single-payer system; in none of those countries is there a movement to abandon their system in favor of ours.)

        In its essential structure, the ACA is a Republican plan. It’s the plan Mitt Romney implemented as governor of Massachusetts, the plan some Republicans proposed when Hillary was trying to enact healthcare reform during the first Clinton term.

        As soon as Democrats proposed it, however, Republicans wanted no part of it. Mitch McConnell and his Republicans cronies in congress got together before Obama was even sworn in and decided that their only goal was to make his presidency a failure, the needs of the American people be damned. Not one Republican voted for the ACA; not one was willing even to negotiate to improve it. Since it was enacted, all the Republicans have done is posture with their scores and scores of bogus votes to repeal it; they’ve never proposed an real alternative for replacing it.

        Seven years after its enactment, they still have no meaningful alternative to it. They know they cannot do away with Obamacare’s most popular features — the prohibition on preexisting-conditions exclusions, permitting dependents to remain on their parents’ plan until age 26, subsidies for lower-income citizens. And somewhere in their benighted brains they know they cannot keep these provisions without enforcing a mandate (unless they totally abandon any pretense to fiscal conservatism and bust the budget). And they have a Republican president who doesn’t give two shits about healthcare, who simply used “repeal Obamacare!” as a slogan to rile up his base.

        Republicans have latched onto this tar-baby with all their empty campaign sloganeering and hollow posturing. Now that they own it, they can’t let go.

        • Carl
          Posted January 14, 2017 at 5:07 pm | Permalink

          If you don’t see a problem with imposing such a major change on half the population that does not want it, I don’t know what to say – it is not healthy for a liberal Democracy. I fear you will now experience being in the imposed on half, though I think your position may be more of a minority by now.

          • Mark R.
            Posted January 14, 2017 at 6:57 pm | Permalink

            liberal Democracy? We’ve been bending towards an oligarchy for a long time. Citizens United sped up the process. The Trump administration imo will make the transition complete. I’d like to know why you, or anyone, would consider the US a “liberal Democracy” or a “conservative Democracy” for that matter. You really think we are a country “ruled by the people”? Statistics prove otherwise.

          • tomh
            Posted January 14, 2017 at 7:00 pm | Permalink

            “If you don’t see a problem with imposing such a major change on half the population that does not want it”

            I guess you would have said the same thing in the 10960s, when Medicare was first proposed. The nation was deeply divided, Repubublicans were dead set against it, with stalwarts like Goldwater likening it to free vacations and beer and Reagan proclaiming it as the destruction of freedom. Fortunately, at the time, there were more farsighted leaders, and they were able to push through what has become the most successful and popular program in the country. History repeats itself with the ACA. Unfortunately, this time Republican intransigence and vote manipulation will pay off for them, and they will scuttle what could have been another health care success.

          • Ken Kukec
            Posted January 14, 2017 at 7:29 pm | Permalink

            Jeez, Carl, I figure one of these days I’ll come back to see you’ve typed “You were right all along, Ken.” 🙂

            Eighty percent of Americans oppose repeal of Obamacare, in whole or in part. The public opposed it initially because the Republicans scared the shit outta ’em with their lies about “death panels” and the like.

            But that’s typical right-wing tactics. They spent that last dozen years of FDR’s administration talking about how they were going to repeal the Social Security Act of 1935. And they fought tooth and nail against Medicare. So did the AMA — but try and repeal it now and see how doctors (and their patients) scream like stuck pigs. There’s a reason the rest of the developed world has single-payer.

            If Trump has his way, they’ll simply tinker with the ACA around the edges and call it “Trumpcare” — the way he used to buy a building, make a few cosmetic improvements, and slap his name on it in yooge gold-leaf lettering.

            • infiniteimprobabilit
              Posted January 14, 2017 at 9:08 pm | Permalink

              “If Trump has his way, they’ll simply tinker with the ACA around the edges and call it “Trumpcare” — the way he used to buy a building, make a few cosmetic improvements, and slap his name on it in yooge gold-leaf lettering.”

              That is the most hopeful scenario.

              From the beneficiaries’ point of view, what does it matter what it’s called so long as they get it.

              cr

              • Ken Kukec
                Posted January 14, 2017 at 9:24 pm | Permalink

                I don’t care, and Barack don’t neither; he’s said as much publicly. Obamacare by any other name would smell as sweet to those otherwise without coverage.

                Trump, on the other hand, doesn’t not care about the name; he doesn’t care period. There’re only two things in the world that matter to the Donald — fame and the mean green. Nothing else comes close.

              • infiniteimprobabilit
                Posted January 14, 2017 at 9:33 pm | Permalink

                Oh, I see rickflick said exactly the same at #13. Great minds…

                cr

              • rickflick
                Posted January 14, 2017 at 11:57 pm | Permalink

                When Trump sells his name for an old hotel and casino, they just tinker about the edges and slap on the big bold letters. He’s accustomed to a glittering lack of substance.

            • Carl
              Posted January 15, 2017 at 12:27 am | Permalink

              Jeez, Carl, I figure one of these days I’ll come back to see you’ve typed “You were right all along, Ken.” 🙂

              Kne, if you ever prove to be right when I’m wrong, I will freely admit it. It’s a point of honor with me. You are a highly partisan Democrat. I’m neither Democrat nor Republican. I can be objective, looking in from the outside. You and some of your counterparts on the Republican side are comical with your constant, overblown vilification of the other side. If either of your opponents were as pure evil as you each make out, I would be living in my cave.

              • Ken Kukec
                Posted January 15, 2017 at 10:27 am | Permalink

                Yes, I am a partisan of the left; I make no bones about it. But you err by claiming I think the other side is pure evil. It is only a segment of the far right I feel that way about — unfortunately, the ideology of that far-right segment has been spreading through the Republican party for years now.

                I have great respect for conservative cut from the cloth of Edmund Burke, for what me might call “classical liberals.” I have praised them (and conceded their points, where applicable) often, including on this site, see here and here.

                I also had much respect for the responsible, cloth-coated Republicans of my youth, like Everett Dirksen or Mitt Romney’s dad, George, and for the moderate Rockefeller-Republican wing of the old Eastern establishment, like William Scranton and Jacob Javitz. Hell, I even held a certain fondness and curiosity about the intellectuals further to their right, like William F. Buckley, Jr., and Russell Kirk. But those strands of American conservatism have all but disappeared now, driven to near extinction by a hard-right element that disparages them as “RINOs.”

                And I always remain open to persuasion, Carl; all it takes to change my mind is evidence and rational argument.

              • Ken Kukec
                Posted January 15, 2017 at 1:11 pm | Permalink

                Plus, Carl, you may want to consider whether your claim that I and other here are highly partisan, while you alone are objective, suffers from the fundamental attribution error.

              • Carl
                Posted January 15, 2017 at 1:52 pm | Permalink

                No, I’m pretty sure I’m always objective, blameless, and right while those who disagree with me are wrong.

          • Ken Kukec
            Posted January 15, 2017 at 11:33 am | Permalink

            “If you don’t see a problem with imposing such a major change on half the population that does not want it, I don’t know what to say – it is not healthy for a liberal Democracy.”

            That sounds like a word-for-word quotation from those who opposed enactment of the Civil Rights Act of 1964, Carl (or who opposed the Social Security Act of 1935, or the Medicare Act of 1965).

            • Ken Kukec
              Posted January 15, 2017 at 12:07 pm | Permalink

              Sometimes the people (especially the more-benighted 49% of them) have to be led, Carl. The art of successful politics often depends upon finding the sweet-spot in society’s vanguard — not too far ahead of the curve, not too far behind — from which that leadership can take place.

              That’s precisely what happened in this nation recently with regard to same-sex marriage. The long run of history may yet prove that it’s what has happened with healthcare reform as well.

              • Carl
                Posted January 15, 2017 at 1:36 pm | Permalink

                Ken, Gay marriage and the ACA are completely different in kind. Gay marriage was/is a rights issue. Even if gay marriage is opposed by 99% of the population, the constitution guarantees the right, even if the government is slow to recognize it – as it obviously was.

                In the practical sphere, recognizing same sex marriage had little effect, except on those enjoying the new liberty. The ACA, on the other hand, has disrupted the health care system in ways that affected many, starting with the miscalculation (not lie!) that people would be able to keep their existing plans and doctors. I couldn’t prove it, but I am convinced if the ACA had never passed we wouldn’t be saddled with President Trump.

          • eric
            Posted January 16, 2017 at 7:04 am | Permalink

            LOL, then what you are saying Carl is that presidential elections aren’t healthy, because they very often impose a major change on half the population that does not want it.

    • gravelinspector-Aidan
      Posted January 14, 2017 at 2:56 pm | Permalink

      That reminds me – I haven’t seen Club Schadenfreude for a while.

    • jeffery
      Posted January 15, 2017 at 11:01 am | Permalink

      I’m also looking forward to the chagrin that Trump voters will feel (I suspect that many of them don’t even know they’re covered by Obamacare) once they realize the implications of the Teapublican agenda- problem is, as one commenter put it, “They’re going to drag the rest of us down with them.”

  3. Edward
    Posted January 14, 2017 at 2:11 pm | Permalink

    “I am scared about what will happen to America within a week, and of course that will affect other nations as well. Our president will be an overgrown, emotion-ridden baby who has no idea what he’s doing; his one agenda is to puff himself up and tear down his enemies, and, I suspect, he doesn’t give a damn about what happens to America in the process.”

    This probably won’t help but I’ll give it a try, credit to Barney Fife 🙂

    Fly away buzzard, fly away crow,
    way down South where the winds don’t blow.
    Rub your nose, and give two winks,
    and save us from this awful jinx.

  4. Posted January 14, 2017 at 2:15 pm | Permalink

    It’s not just “poor people” who use Obamacare.

    We use it.

    My husband and I own our own businesses, operated as sole proprietors. We are nearing our 50th decade on this planet, and each of us have “pre-existing conditions”. Without the Affordable Care Act, we wouldn’t have health care. We don’t make so little to qualify for Medical/Medicare, but we don’t make enough to pay the big bucks for a high quality health plan (which can be close to $2k a MONTH).

    • DIck Veldkamp
      Posted January 14, 2017 at 2:35 pm | Permalink

      If you are nearing your 50th decade, your health is extraordinary. 😉

      • Posted January 14, 2017 at 2:42 pm | Permalink

        Ha! 5th decade, I meant… or would that be our 6th? Ug, now I’m totally confused.

      • Ken Kukec
        Posted January 14, 2017 at 4:34 pm | Permalink

        Methuselah called; he’d like some longevity tips. 🙂

  5. Reginald Selkirk
    Posted January 14, 2017 at 2:20 pm | Permalink

    Every “Unified Republican Government” Ever Has Led to a Financial Crash

    • Ken Kukec
      Posted January 14, 2017 at 4:59 pm | Permalink

      “Mister, we could use a man like Herbert Hoover again”?

  6. Chris Laraia
    Posted January 14, 2017 at 2:21 pm | Permalink

    I’m glad you touched on the political implications of Determinism here. Whenever Determinism is discussed, it seems the only real-world implication discussed is crime and punishment. I think this is a mistake because the political ramifications of determinism are (to my mind) absolutely enormous and would directly affect people’s day-to-day lives in ways that prison reforms wouldn’t.

    The entire edifice of right wing political thought is built upon an absolute belief in free-will. Objectivism explicitly so. I would love to see a post from you or any other prominent advocate of Determinism (Sam Harris, etc) to consider it’s various political ramifications.

    • Gregory Kusnick
      Posted January 14, 2017 at 2:54 pm | Permalink

      Not the entire edifice: Social Darwinists are determinists who believe that poor people are poor not because they make poor choices, but because it’s their biological destiny to be poor.

      So denying that people make choices doesn’t automatically lead to compassion and better treatment of the poor. It can just as easily be used (and historically has been used) to dehumanize the underclasses and support the status quo.

      • reasonshark
        Posted January 15, 2017 at 8:21 am | Permalink

        And what is “destiny” but the ultimate libertarian free-will entity, who like God chooses the Chosen Ones to achieve greatness and bring down (or at least profit from) the undeserving? Who acts as a kind of psychic thermostat on the balance of good and evil? Who instills a human-privileging purpose into the universe?

        Social Darwinism relied on the Just-World Fallacy, and that fallacy’s always been fundamentally about moral human exceptionalism. It makes no sense whatsoever in a coldly causal universe because the idea that the poor are causal flotsam in an indifferent universe is anathema to the idea that they were chosen – by destiny – to fulfil a societal function for some superior purpose beyond the ken or capacity of humans.

        The very notion of a purpose-driven universe is incompatible with a purely cause-and-effect driven one, or even to a purely random, causeless one. Determinism and destiny are at odds with each other. Social Darwinists are pseudoscientists even after you ignore the flagrant misinterpretation and misapplication of Darwin’s theory.

    • Petu W.
      Posted January 15, 2017 at 3:26 am | Permalink

      Very good point!

      “Trump and other republicans are victims of their genes and environments.” They do what they do…

    • Diana MacPherson
      Posted January 15, 2017 at 11:48 am | Permalink

      I’m doing a talk in Las Vegas about Agile as applied to a project I ran. I was looking for an image about Mindset and although I agreed with this whole thing (it’s a concept by a Stanford psychologist) the ending was so wrong that I had to find another image to borrow. They mix up determinism with fatalism and suggest “a greater sense of free will” is part of a “growth mind set”. Ugh.

      • GBJames
        Posted January 15, 2017 at 11:55 am | Permalink

        Jeebus, that really does fall apart at the end.

        Maybe the person who created the drawing needs to find a diagram about how logical reasoning works.

        • Diana MacPherson
          Posted January 15, 2017 at 12:07 pm | Permalink

          And there are a few of them out there like this. I suspect there is some religion behind the conclusion.

  7. Mark R.
    Posted January 14, 2017 at 2:21 pm | Permalink

    The main reason is to give money back to the rich. Hundreds of billions I think. This is the main reason. Yeah, they don’t give a shit about poor people, but they do give a shit about the top 2%. So repealing the ACA gives back the tax cut that Obama used to fund the ACA’s reimbursement program. It’s always about the money with the republican greed machine.

    • gravelinspector-Aidan
      Posted January 14, 2017 at 3:01 pm | Permalink

      Yeah, they don’t give a shit about poor people, but they do give a shit about the top 2%.

      Two sides of the same coin for most right-wingers I’ve ever met. Without the visceral fear of ill health and/ or starvation, the 98% might start to become uppity – bolshy, even – and start to resist being exploited by the 1%. And that will reduce profits because they’ll need to hire more police and arm them more heavily to keep the peons in their place.

      • infiniteimprobabilit
        Posted January 14, 2017 at 9:16 pm | Permalink

        Oddly enough, they never mind paying for more police and guns and prisons…

        cr

  8. Richard Jones
    Posted January 14, 2017 at 2:23 pm | Permalink

    The rich man in his castle, the poor man at his gate…
    The Lord God made them all!

    I feel for you America.

  9. Randall Schenck
    Posted January 14, 2017 at 2:26 pm | Permalink

    A very few of the news people, journalists who still know what the definition is suppose to mean are covering some of this. They are out finding people who are now covered by the health care and have some real health issues and are very worried. Some of them even voted for Trump. Buyer’s remorse if there ever was one. Before it is all underway, most of the millions who voted for this turd will be in full regret. The really rich will get richer and the rest will try to remember why in the hell they voted for this.

    The republicans think they have a plan but it is really no plan. As long as the private insurance companies run the show, and they do, the people will be screwed. There is only one word to solve health care in America and that would be medicare for all. One payer system that takes on directly the health care providers, hospitals and big pharma. Not going this way in the beginning was a big mistake but cannot be blamed on Obama – this country was not ready for it and apparently still is not. Never do the right thing until everything else has failed.

    • gravelinspector-Aidan
      Posted January 14, 2017 at 3:08 pm | Permalink

      Never do the right thing until everything else has failed.

      Churchill?
      Well, he was only half-a-merkin so probably wasn’t wrong all of the time.

  10. harrync
    Posted January 14, 2017 at 2:31 pm | Permalink

    About your point 2): I suspect it is not just that they don’t care about the poor, but actually want to see them suffer. Throughout history, it seems Christian theologians have said one of the joys of going to heaven is watching the damned suffer. [http://www.tentmaker.org/Quotes/hell-fire.htm] So why wouldn’t many of the rich today enjoy seeing the poor suffer? And I would add 3): the worse off poor people are, the cheaper they will work flipping hamburgers.

    • gravelinspector-Aidan
      Posted January 14, 2017 at 3:10 pm | Permalink

      The Argument From Mother Theresa? Argumentum Madrea Theresiensis? I’m sure that Latin could survive a little more torture. Perhaps a little Greek?

  11. veroxitatis
    Posted January 14, 2017 at 2:37 pm | Permalink

    Is it not the case that a significant number of these poor who, but for “Obama Care” would have no, or inadequate health care, are Republican voters?

    • infiniteimprobabilit
      Posted January 14, 2017 at 9:31 pm | Permalink

      Almost certainly.

      My father, living in his council-provided (low-rent) old peoples’ flat on his government-provided pension, used to follow the right-wing party line and whinge about welfare beneficiaries cheating the system. Cognitive dissonance is not only a feature of religion.

      cr

      • infiniteimprobabilit
        Posted January 14, 2017 at 9:41 pm | Permalink

        (That was in New Zealand, I should add for context).

        cr

  12. Posted January 14, 2017 at 2:58 pm | Permalink

    To paraphrase Jon Stewart, “Poor people don’t have lobbyists.”

    • Kevin
      Posted January 14, 2017 at 11:05 pm | Permalink

      Poor people can pray to Jesus for good health.

      I just wish all the Christians against Obamacare would stop seeing any doctors and put faith in their God for healing.

  13. rickflick
    Posted January 14, 2017 at 2:58 pm | Permalink

    Best case scenario: The GOP adopts a new health insurance plan much the same as Obama Care, but with a few fig leafs attached so they can call it Trump Care.

    • eric
      Posted January 16, 2017 at 7:10 am | Permalink

      I was hoping for that too, but both Trump’s recent comments and Ryan’s older proposals replace the ACA’s laws against charging more/different/denying coverage on the basis of pre-existing conditions with high-risk pools. This would essentially be a huge step backwards for anyone with ill health, causing their health care costs to skyrocket (either because their plans become far more expensive, or because they are simply denied coverage).

  14. Posted January 14, 2017 at 3:04 pm | Permalink

    I think the two reasons you cite for the Republican’s desire to repeal Obamacare are actually a caricature of what’s really happening. The way you portray them, they’re, first, intent on destroying Obama purely for the sake of prestige, and two, just against poor people. Here’s my understanding of the need to repeal Obamacare. It is a deeply flawed policy that tries to centralize healthcare through the federal government. Here are three compelling reasons to repeal: 1) rising premiums. Premiums are going through the roof, especially in Arizona, where they are set to more than double. 2) High deductibles. The deductibles are so high that you may as well not have insurance. 3) Lack of choice. In some places, there is only one insurer available. There is a path to replacement, and it will involve localized control over healthcare and greater competition.

    • Carl
      Posted January 14, 2017 at 3:29 pm | Permalink

      Excellent statement of the true problem without resort to hand wringing and emotion.

      • DireLobo
        Posted January 14, 2017 at 9:36 pm | Permalink

        Absurd regergitation of untrue talking points.

        1. Premiums are only rising in states which did not embrace medicare expansion, which was gutted because of the supreme court allowed states to “opt-out”.

        2. High deductibles: no higher than normal plans you could buy yourself (ie. high deductibles).

        3. In some places Republican policies (ie. failure to allow medicare expansion) have forced insurance providers to back out of markets because these policies make it impossible to provide a product without losing money.

        In short, in states where the Medicare Expansion was allowed, things are stable, deductibles are competitive and options are broad. In (red) states where a-holes blocked full implementation (in order to destroy the program) rates are rising higher, choices are fewer and therefore people in those states are not thrilled, like you describe.

    • Historian
      Posted January 14, 2017 at 3:44 pm | Permalink

      I do not buy your Republican talking points. Yes, premiums have gone up, but most recipients of the ACA get subsidies. It has helped millions of people and saved lives. You state you are against centralized healthcare from the federal government. I bet you’re just hankering for the repeal of Medicare, one of the most popular programs ever coming out of Washington. And like all Republican attacks on the ACA, we get nothing but vague promises for some better plan that is cheaper with as good coverage. Seven years have gone by since the passage of the ACA and still no Republican plan.

      There has been a report today about a person on the ACA whose life was saved because of the ACA. He confronted Paul Ryan with and got nothing back but the usual Republican mumbo-jumbo.

      https://www.washingtonpost.com/news/to-your-health/wp/2017/01/14/cancer-survivor-who-challenged-ryan-the-aca-saved-his-life/?hpid=hp_hp-top-table-main_tyh-survivor-932am%3Ahomepage%2Fstory&utm_term=.02ebac6e92d5

      The total contempt that the Republican Party has for the less advantaged never ceases to amaze me. Republicans dupe the masses and then screw them time after time. It’s been a winning strategy, so I guess it won’t be changing any time soon. Republicans don’t care that people suffer because of the lack of insurance. Deregulation and small government are so much more important.

      Paul Krugman demolishes the Republican delusions in this column.

      • rickflick
        Posted January 15, 2017 at 12:24 am | Permalink

        Krugman points out that if the GOP actually do repeal and not replace, they’ll try to find a way to blame the subsequent disaster on Obama.

        • Posted January 16, 2017 at 11:55 am | Permalink

          No doubt: they are still blaming Bill Clinton and JFK and Roosevelt for stuff.

    • ajlowry
      Posted January 15, 2017 at 4:05 am | Permalink

      Fellow Arizonan here. My premiums went up 400% from what they were before the ACA, and I now have a $5000 deductible. If I had $5000 under the mattress, I wouldn’t need the insurance so much.

      • Posted January 15, 2017 at 8:47 am | Permalink

        Yes, thanks for sharing this. The ACA is actually pretty unpopular, even though there may be anecdotal evidence that some people have benefited.

        • Somite
          Posted January 15, 2017 at 9:00 am | Permalink

          You only have republican sabotage and insurance company greed to thank for that.

          BTW; nothing republicans have proposed would prevent insurance companies or providers with charging as much as they want.

        • rickflick
          Posted January 15, 2017 at 9:52 am | Permalink

          Over the years approval runs around 40% to 50%. “Today about three-quarters (73%) of Democrats approve of the law, while 85% of Republicans disapprove. Independents are roughly as likely to approve (52%) as disapprove (45%), though independent views of the law have grown more positive in the wake of the election”.

          http://www.pewresearch.org/fact-tank/2016/12/08/partisans-on-affordable-care-act-provisions/

      • GBJames
        Posted January 15, 2017 at 9:35 am | Permalink

        “I wouldn’t need the insurance so much.”

        Apparently you are not old enough to know how much a hip replacement costs.

      • eric
        Posted January 16, 2017 at 7:18 am | Permalink

        Republican Governor Jan Brewer refused to allow a state-run health insurance exchange to be set up in the state.

        And then when the state doesn’t have a competitive markeplace of insurance brokers, you blame that on structural elements of ACA rather than the Governor’s decision. You blame it on DC Democrats rather than your GOP head of Arizona. This is like the poster child for confirmation bias.

        Here’s a thought: the lack of competition driving down prices might be due to your conservative Governor blocking the formation of a competitive marketplace. I know what you’re going to say – “eric, that’s just crazy talk. No way the increasing prices could be linked to the Governor’s decision!” But just consider it for a second.

    • Keith
      Posted January 15, 2017 at 4:36 am | Permalink

      Your claim that Obamacare centralizes health care through the Federal government is not even remotely true. Even Medicare doesn’t do that. For all its faults, Obamacare does make it easier for private, for-profit health insurance companies to enter markets and offer their products to customers previously priced out of the system. The legislation would work much better if all states had signed onto the Medicaid expansion as intended and if everyone eligible would participate. A much better approach to affordable and universal coverage would be to expand Medicare to everyone (i.e. single payer).

      Republicans philosophically oppose helping poor people and philosophically favor the wealthy. The evidence for this claim is overwhelming from any fair reading of history.

    • Posted January 15, 2017 at 5:20 pm | Permalink

      All three of your points are legitimate concerns. However, they mostly apply to people who would not have been able to afford health insurance at all due to to low income and/or pre-existing conditions in the first place.
      For those who had employer-provided health insurance (over 60% of Americans, I believe), premiums have been going up with or without the ACA.

      • Posted January 15, 2017 at 7:36 pm | Permalink

        So what’s your point? Rising premiums are bad. Premiums have risen because the ACA has tried to regulate the insurance industry for forcing it to provide plans that have a certain level of coverage. What this has done is eliminate cheap, or catastrophic plans, plans for someone who is very healthy and needs insurance only if a freak accident were to occur. This has driven away young and healthy people from buying plans. The problem is that insurance companies need young and healthy people to stay in business. The young and healthy pay a premium and are cheap for the insurance companies because they don’t get sick and don’t need insurance. If only sick pay for plans, the insurance companies will go out of business or raise their premiums, which is what has happened. The sick are very expensive for the insurance companies.

        • Posted January 15, 2017 at 8:48 pm | Permalink

          What you are describing is the situation on the private market prior to the ACA. Without the ACA mandate, there is even less reason for young and healthy people to buy health insurance – given high premiums, they opt out or pick the cheapest catastrophic coverage that doesn’t really do much to make up the insurance company’s losses on the expensive coverage the old and sick people get. So the premiums rise, pricing out more healthier people, and that causes them to go up even further. The insurance controlled premiums by cutting out pre-existing conditions, which for many defeated the purpose of having the insurance in the first place. After ACA, the same dynamic still exists, but is moderated by requirement that the young people insure or pay the fine (which is used to pay for coverage), by subsidies that make policies more affordable, by expansion of Medicaid.

  15. GBJames
    Posted January 14, 2017 at 3:05 pm | Permalink

    It is a horror show, for sure.

    Keep your eye on Mike Pence. He’s going to be the actual president. Trump will be gone before a year has passed.

    Then things will get even worse.

    • gravelinspector-Aidan
      Posted January 14, 2017 at 3:14 pm | Permalink

      Trump will be gone before a year has passed.

      High velocity lead, AIDs picked up in a Moscow hotel room, or something interesting?

      • GBJames
        Posted January 14, 2017 at 3:24 pm | Permalink

        He has no real support among Republicans in Congress and they can’t control him. He’s going to provide so many examples of ethical, if not actually criminal, behaviors that Republicans will simply decide to hand it over to Pence. He’s not even in office yet and the shit is already hitting the fan daily.

    • charitablemafioso
      Posted January 14, 2017 at 3:25 pm | Permalink

      Agreed with this. I’ve suspected for awhile now Pence will do the actual governing, whether or not Trump holds the title of POTUS. Pence actually has political experience whereas Trump is woefully in over his head. I can’t decide if I find the thought of a Pence presidency (de facto or official) scarier than a Trump presidency. I find Trump worrisome because most of his policies are unknown at this point (I suspect even to him). And what we do is disturbing (that stupid border wall with Mexico, his crush on Putin). We do know what Pence’s policies are, and they are unpalatable in the extreme, especially on issues such as healthcare (general and women’s) and gay rights. OTOH, this country has had religious right presidents in the past and perhaps there is something to be said about the devil you know. I’m on the fence as to who would do a worse job both domestically and internationally.

      • gscott
        Posted January 14, 2017 at 5:27 pm | Permalink

        I agree that someone else will be doing the governing (if any actual governing gets done), but I think we’ll have to wait and see who or what it is. It may be Pence, it may be the Bavarian Illuminati, but someone will be pulling the strings.

      • rickflick
        Posted January 14, 2017 at 5:59 pm | Permalink

        “I’m on the fence as to who would do a worse job both domestically and internationally.”

        I’m thinking Trump is just too unpredictable and dangerous. Pence, while highly undesirable, would probably stay within certain loose bounds of consistency. I’ll take 4 years of Pence before the Donald.

  16. tubby
    Posted January 14, 2017 at 3:15 pm | Permalink

    I suspect it’ll be repealed with a three year float. Trump will be unable to force the republicans to actually put together a bill, and doesn’t have the know how to have one put together for the congress to modify. During the first two years they will hold it hostage for every item on their agenda to get democratic cooperation. The republicans will run on the bill in the next election claiming they’re going to bring Trumpcare to the nation, which will be described bigly. In year three the republicans will loudly and constantly blame democrats for the lack of a bill, even if by this time they have yet to propose anything. In year four they will run on blaming the democrats for a lack of a healthcare bill, and a surprising number of voters will agree with them and vote republican.

    • Historian
      Posted January 14, 2017 at 3:50 pm | Permalink

      Your analysis is quite plausible. This may be the master plan of Mitch McConnell, the most Machiavellian and, therefore, the most dangerous of all Republicans.

      • tubby
        Posted January 14, 2017 at 6:38 pm | Permalink

        I make a big assumption that the parties that want this gone feel it’s worth milking a replacement for leverage or votes and will simply run with ‘small government’ and stopping ‘wealth redistribution’ to the unworthy. (Fox’s Gutfeld Dismisses Real Life Consequences Of Health Care Repeal: “You Should Feel No Shame Burning This Bill”) Trump may forget about it once it’s no longer politically convenient and the parties it does matter to, regardless of party, may be unable to out shout the people who want it gone. Any negative consequences will be blamed on Obama either way though.

  17. mfdempsey1946
    Posted January 14, 2017 at 3:23 pm | Permalink

    “Republicans have shown a persistent callousness towards the poor, adhering as they do to a ‘just world’ theory that the poor deserve what they get.”

    Correct. Ask why poor people are poor, and the Republican answer will be something like this:

    “Because each and every one of them is a lazy bum who doesn’t want to work. This is the one and only reason why poverty exists. If the poor were honest, hard-working, nose-to-the-grindstone workers like us, they would be rich, too. They have nobody to blame but themselves for their problem. So stop whining about them.”

    Today’s Republicans, members of the most obscene political entity in US history, apparently swear by ghost-in-the-machine free will, implanted in everyone by Sky Daddy. This makes all of us totally to blame for any misfortune that afflicts us.

    Social arrangements, on the other hand, that give the 1% every kind of leg-up from the get-go over everybody else must never be faulted, of course.

    It is so dismaying to witness the return of this supposedly long-discredited ideology of raw, insatiable greed for mountains of money and the deep pleasure that derives from having the power to make life as miserable as possible for the largest possible number of people.

    Are we entering a new era of Social Darwinism? If so, it is likely to surpass any other era of this sort in unabashed cruelty.

    • Posted January 14, 2017 at 8:45 pm | Permalink

      Disagree. Republicans feel that people of color are lazy bums who don’t want to work and so are poor. The poor whites in Kentucky are that way because of unions, liberals, and regulations.

  18. jay
    Posted January 14, 2017 at 3:32 pm | Permalink

    The unspoken assumption is that Obamacare is really a good thing. It’s disrupted a lot. Many of us who already had coverage have been hit with big increases as the cost of insurance shifts the burden to the already insured.

    It’s based on financial assumptions that were wildly unrealistic, and would collapse under its own weight anyhow. Better to do it now.

    Republicans are not as stupid as the Democrats like to portray them. They know (and Trump has said so) that anything must have a suitable replacement. I don’t expect there will be an abrupt pulling of the plug.

    • GBJames
      Posted January 14, 2017 at 3:41 pm | Permalink

      Except that’s not really true. The cost of health insurance rose much more rapidly in the decade before the ACA than it did after.

      And I think you are dead wrong about Republican intent. Conservatives have opposed every expansion in health coverage since FDR. Every one. Even if it was devised by a Republican Governor named Romney under the guidance of the (old) Heritage Foundation.

      There will be no replacement following repeal. If one was in the works we would have been hearing details of it for years while the “repeal and replace” chant has been going on.

      • tomh
        Posted January 14, 2017 at 6:42 pm | Permalink

        You are right that there is nothing new about Republican opposition to health care. In the early 1960s, when Medicare was first conceived, none other than Ronald Reagan taped a recording warning that:

        “If Medicare passes into law, the consequences will be dire beyond imagining,” Reagan said. If opponents failed to defeat it, “One of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.”

        • Ken Kukec
          Posted January 14, 2017 at 8:20 pm | Permalink

          That was around the time the Gipper was hosting Death Valley Days and hawking 20 Mule Team Borax soap during commercials. How’s that product doin’ now?

          About the same as the opposition to Medicare, far as I can tell. Cranks and Birchers and survivalists camped out in the desert waiting for Armageddon are the only fans left of either.

        • somer
          Posted January 14, 2017 at 8:47 pm | Permalink

          America is unique in its opposition to public health care. Part of American identity for much or most of the population seems to be opposition to a public safety net other than thoroughly piecemeal because otherwise the dreaded central government would have some meaningful control of an area outside the military. And I totally agree with Jerrys assessment of His Worship the Trump. A reader referred to Trump as Napolean (as in the Pig in Animal Farm) and he so reminds me thereof except he’s probably a lot less organised. Not that the Republicans and their supporters care a jot. They want to concentrate on religion, kick the poor, keep out/or down those different from themselves and pretend the rest of the world and its influences don’t exist. And those who voted for him for economic reasons will be disappointed. Perhaps the US has always been a fundamentally divided country and its tortuous political system diffuses the tensions and allows politics to pass periodically from one side to the other, whilst also obstructing strong national domestic policy that would help the disadvantaged in an dependable ongoing way. And for a light relief current sample of Trump’s narcissism
          http://www.bbc.com/news/world-us-canada-38578885
          Trump’s ‘Soft Sensuality’ inauguration

          • Ken Kukec
            Posted January 14, 2017 at 9:44 pm | Permalink

            “No one believes more firmly than Comrade Napoleon that all animals are equal.”

            “No one has more respect for women and minorities than me, Donald J. Trump.”

            Yeah, I’d say ya got yourself a point there, somer.

          • rickflick
            Posted January 14, 2017 at 11:49 pm | Permalink

            “It’ll be about the people, not about him”.

            Yup.

    • Ken Kukec
      Posted January 14, 2017 at 7:48 pm | Permalink

      “Republicans are not as stupid as the Democrats like to portray them.”

      I’d be a lot more amenable to that assertion if they hadn’t nominated a vulgar, orange clown to lead their party and be our president.

      This is no time in our nation’s history to be directing attention to the GOP and intelligence in the same sentence.

      There are 20 million of your fellow citizens who have healthcare now, who wouldn’t otherwise. Some of those people are alive today because of Obamacare. You can contend that’s a bad thing if you want to, but it’s gonna be a tough sell.

  19. Steve Brooks
    Posted January 14, 2017 at 3:44 pm | Permalink

    I am 74 years old. This coming inauguration scares me more than any other particular event in my life.

    • Historian
      Posted January 14, 2017 at 4:18 pm | Permalink

      You’re not alone.

      • Ken Kukec
        Posted January 14, 2017 at 8:23 pm | Permalink

        No one is old enough not to say that. Not this nation itself.

  20. C Mack
    Posted January 14, 2017 at 3:45 pm | Permalink

    PCC(E) wrote: “I can’t for the life of me see any reasons why the Republicans are dismantling Obamacare save two…”

    PCC(E) I believe is giving Republicans in particular, and conservatives and Trumpists in general, more credit than they’re due. I feel like there is a large majority of the aforementioned groups that simply score very low on scales of empathy and altruism. They are reactionaries who would really like to see us return to the pre-New Deal era. An earlier comment mentions an affinity for Social Darwinism, which is quite an apt description whether in the guise of Libertarianism, Randian Objectivism, or just plain old greedy, selfish, penuriousness. Particularly when the beneficiaries are “Undeserving Deadbeats” which is of course coded speech…

    So, I don’t find it a mystery – I grew up in the homogenous rural Midwest and am all too well acquainted with the type…

    • Historian
      Posted January 14, 2017 at 4:01 pm | Permalink

      I read this article about the Trump supporters of Iowa. I recommend it to all. The key sentence in the article is this observation by the reporter: “And overwhelmingly, Trump supporters did not want their hard-earned money redistributed to people they regarded as undeserving.” Most Trump supporters are not the poorest of citizens, but they are terribly afraid that the poor are going to steal their money and drop them down into poverty. Republican propaganda, disseminated endlessly and relentlessly, has been remarkably successful. The divide-and-conquer tactics have turned the working class against each other. Nothing makes the wealthy elite that controls the Republican Party any happier.

    • barn owl
      Posted January 15, 2017 at 7:12 am | Permalink

      I’m surprised that their heads are visible in that photo, because I would have guessed that they were stuck up the nether parts of their anatomy. Some are the kind of people who flail and rage about big government with one hand, and take federal agriculture subsidies and tax breaks with the other. Just like the Bundys.

      And if they want drug-testing for welfare recipients, then by all means let’s start with their white neighbors in the trailer parks and blighted rural rental properties.

  21. Greg Geisler
    Posted January 14, 2017 at 4:29 pm | Permalink

    I would agree with both of your assumptions about the repeal. I would also suggest that race factors into both. I also firmly believe that #2 is an important cornerstone of their climate change denial. It is simply not within the realm of possibility that many of these Republican deniers are actually so ignorant as to not believe the evidence. Some, but not all. Instead, they are well aware that the people who will suffer first and most are the poor and minorities—whether they live in the USA or in underdeveloped countries.

    Here is a link to a graphic that details who will be impacted by the repeal of ACA.
    https://pbs.twimg.com/media/C2EgeDsUsAAP2QC.jpg:large

    • Historian
      Posted January 14, 2017 at 4:40 pm | Permalink

      The chart you linked to should be viewed by all. Perhaps some of those people who so ardently oppose the ACA will change their minds.

  22. Mike Cunningham
    Posted January 14, 2017 at 4:31 pm | Permalink

    A couple points. 1) premiums and deductibles were going up several years before the ACA became law and I predict they’ll continue to rise after the repeal. 2) Besides the 20+million who will be impacted by the repeal, let’s not forget the 11 million Medicare beneficiaries who will be impacted because the ACA helped close the so-called doughnut hole for their prescriptions.

  23. Ken Kukec
    Posted January 14, 2017 at 4:52 pm | Permalink

    The Republicans main advantage is that they exercise political power much more ruthlessly — look at their savage gerrymandering of congressional and legislative districts, at Mitch McConnell et al.’s obstruction of Judge Garland’s confirmation process. Look at the coup pulled by the North Carolina legislature in stripping power from the newly elected Democratic governor before he could take office.

  24. E C Siegel
    Posted January 14, 2017 at 5:04 pm | Permalink

    I am 78. I thought Nixon would be the worst president of my lifetime. I was wrong.

    Someone said of FDR that he had a second rate intellect but a first rate personality. Where would Trump be on that scale?

    • Ken Kukec
      Posted January 14, 2017 at 8:38 pm | Permalink

      As to his intelligence, it’s like the lady’s complaint about the diner food in Annie Hallterrible … and such small portions, too.

      As to his personality — bitter, mirthless laughter prevents me from typing further.

  25. Posted January 14, 2017 at 5:13 pm | Permalink

    I will be boycotting the TV broadcast of the Inauguration of an Ass. He is above all else hungry for attention and power. Ignore him on his ‘tremendous’ day.

    • Randall Schenck
      Posted January 14, 2017 at 6:14 pm | Permalink

      I will attempt to ignore the whole show for the next 4 years, assuming he last that long.

      • Ken Kukec
        Posted January 14, 2017 at 8:47 pm | Permalink

        Not me. I’m not letting the bastard outta my sight — every move he makes, every vow he breaks, every step he takes.

      • Ken Kukec
        Posted January 14, 2017 at 9:13 pm | Permalink

        Oh, hell, lemme just quote Tom Joad’s speech from Mr. Steinbeck’s Grapes of Wrath:

        “It don’t matter, then. I’ll be all around in the dark – I’ll be everywhere. Wherever you can look – wherever there’s a fight, so hungry people can eat, I’ll be there. Wherever there’s a cop beatin’ up a guy, I’ll be there. I’ll be in the way guys yell when they’re mad. I’ll be in the way kids laugh when they’re hungry and they know supper’s ready, and when the people are eatin’ the stuff they raise and livin’ in the houses they build – I’ll be there, too.”

        • barn owl
          Posted January 15, 2017 at 7:15 am | Permalink

          +1

      • Posted January 15, 2017 at 6:28 am | Permalink

        I was suggesting just a one-day boycott so that the TV ratings of his inauguration plummet. That will irk him. Like Ken, I think we have to keep scrutinizing him and his sorry attempts at policy-making.

        • Posted January 15, 2017 at 8:14 pm | Permalink

          “The Hollow Crown” would be a far better thing to watch.

          • GBJames
            Posted January 15, 2017 at 8:16 pm | Permalink

            Indeed.

  26. Posted January 14, 2017 at 5:15 pm | Permalink

    “Would any of us have not laughed at that possibility a year ago?”

    I was not laughing. But I can — and I mean this genuinely — thank those here who assured me it was impossible that he would win. I would otherwise have spent that whole election cycle in the dread that I feel now.

    Now Germany (like France) has to deal with electoral sabotage by both Putin and Trump. I know the CIA often meddled in elections, but never as openly as what Putin does (the brazenness is part of the destabilizing strategy), and Trump is starting to do. The coming US/USSR alliance will lead to the end of democracy for many countries, not just the US.

    • Carl
      Posted January 14, 2017 at 5:38 pm | Permalink

      The coming US/USSR alliance will lead to the end of democracy for many countries, not just the US.

      I’ve always felt that second amendment defenders were being silly arguing we may need guns to fight the government. Are you saying this is a legitimatize argument now?

      • Posted January 14, 2017 at 6:33 pm | Permalink

        No.

        For the US I meant more the destruction of the democratic nature of organs of state as Trump turns your country into an oligarchy.

        But the countries Putin will soon invade will lose their democracy, and those whose electoral systems will be undermined by the combined resources of Russian intelligence and whatever weapons Trump can get his hands, face an extremely difficult future.

        I hope I’m exaggerating, but I think it’s more likely to be massive understatement. The view is a bit different here from Europe. To me at least. The US defended itself after 9/11, but it has just opened its doors to a far more dangerous enemy. And sadly, many other countries, who unlike the US do know what it is like to be invaded, were counting on NATO for protection.

        • Carl
          Posted January 14, 2017 at 7:23 pm | Permalink

          I agree with you about the threat Putin poses. Russia has already lost its democracy. Putin is a very bad actor. The relation Putin has with the U.S. remains to be seen. At least some in Trump’s cabinet seem more aware of Putin’s nature than Trump himself. But I don’t feel American democracy is remotely in danger.

          • Ken Kukec
            Posted January 15, 2017 at 11:48 am | Permalink

            Putin is a very bad actor.

            No. Ben Affleck is a very bad actor; Putin is a war criminal and thug. 🙂

            • Carl
              Posted January 15, 2017 at 1:12 pm | Permalink

              No. Ben Affleck is a very bad actor; Putin is a war criminal and thug. 🙂

              Again, I disagree with you. Affleck is a very good actor, and has made some very good movies. My loss that I can’t stand watching him onscreen any longer.

              • Ken Kukec
                Posted January 15, 2017 at 2:46 pm | Permalink

                I actually agree about Ben Affleck being pretty good, at least in character roles (as in Argo and Smokin’ Aces).

                It’s in leading roles that he tends to be “wooden” (although he put that woodenness to good use as the distant husband in Gone, Girl).

                Wasn’t “wooden” your characterization of his acting? That’s why I used his name as the “bad actor.”

              • Carl
                Posted January 15, 2017 at 2:58 pm | Permalink

                I don’t think I ever described Affleck’s acting as wooden. I only watched a couple minutes of Gone Girl – that was my realization I couldn’t stand watching him any more.

              • GBJames
                Posted January 15, 2017 at 5:00 pm | Permalink

                He would probably do a good job in the character of Woden. No?

        • Posted January 15, 2017 at 1:43 am | Permalink

          NATO is not only USA. (Actually, it is, but it shouldn’t be.) I think it is high time for Europeans to take care for their security themselves. Not that I expect it to happen.

          • Posted January 15, 2017 at 7:13 am | Permalink

            The point of NATO was to keep the Russians at bay. Europe is still conducting this project and will certainly not be requiring help from an enemy state that has already capitulated.

    • Ken Kukec
      Posted January 14, 2017 at 8:56 pm | Permalink

      What worries me is that the Russians might have a video of Trump insulting the disabled and POWs, or even admitting to sexual assault, that they could use to blackmail him into doing their bidding.

      Only a feverish, paranoid delusion, I know.

      • Posted January 15, 2017 at 1:45 am | Permalink

        With all things he is saying openly in front of cameras, I cannot imagine what more of this sort they may have to use for blackmail.

        But they may blackmail him with something else (a nasty deal e.g.)?

        • Ken Kukec
          Posted January 15, 2017 at 10:49 am | Permalink

          There is something very strange going on with Trump and Vladimir Putin/Russia. That much has been clear at the least since the GOP convention, when Trump — who didn’t care about the Republican party platform, which in many ways contradicted his stated policies — had his people fight to change just one of that platform’s planks: the one supporting opposition to Russia’s incursions into the Ukraine.

          Since then, the evidence of Trump’s weird Russia connection has continued to pile up.

      • Posted January 15, 2017 at 7:06 am | Permalink

        I read somewhere that the Russians wrote him off and pulled funding from their trolls when he started insulting that Muslim family.

      • somer
        Posted January 16, 2017 at 7:58 am | Permalink

        Like what won him the election! There seems to be no low that tarnishes him. Fake is the new Real.

  27. Posted January 14, 2017 at 6:25 pm | Permalink

    Republican politicians are motivated first to cater to their right-wing base and, second, to figure out ways to game the system to their advantage. The Affordable Care Act is perceived by GOP voters as a welfare program. Those voters do not understand that, without near-universal coverage, everyone’s medical care bills are higher because providers can’t bear the costs of the uninsured (who do have to be treated, at least to some extent and even if only in the emergency room). That, in turn, touches on the GOP driving force: race. The Republicans are likely to delay the effectiveness of repeal so that they can figure out a way to blame the Democrats. The Democrats will, as they often do, negotiate with themselves and bargain for crumbs and fail to exercise whatever advantages they have. The goal for the GOP will be to hold majorities in 2018.

  28. Nancy Holst
    Posted January 14, 2017 at 6:28 pm | Permalink

    My husband and I have not had to utilize the ACA. My husband is retired after working nearly 30 years on a Fire Department.

    Our household monthly expenses for healthcare are as follows: $678.00 for husbands BCBS premium (his employer did not covered medical upon retirement but he does get a pension), $160 ish (I’d have to check for exact amount) for MY Medicare disability Part B premium (I have MS and after hiring an attorney, was able to qualify). I also have my own BCBS supplemental policy that costs me $278.00 monthly. I have NO prescription coverage. My MS treatment consists of a monthly infusion which is covered by Medicare and BCBS since it is considered a medical treatment and NOT a prescription drug. I am on 2 additional prescription meds which are an additional $100.00 each month. We have NO dental coverage at all. So, not counting dental expenses, we pay $14,592 annually for healthcare.

    It seems to me that something is wrong here that has nothing to do with the ACA. The entire for profit health care industry in this country is broken and in some instances corrupt, just like our government. For example, when I pick up my medications each month from the pharmacy (I won’t say which one but it is one of the major ones in the Chicago area), they always give me the price and this price changes almost every month. I always tell them I don’t have prescription coverage and they say something like “One minute, let me check something”. Then they go talk to the pharmacist and somehow the price gets adjusted downward. I even had the pharmacist look at me one time and wink. I am not making this up. I go through this every month. One would think that they would have it on record that I don’t have rx coverage and then they would not have to “check” w/ Ms. Winky pants for random adjustments to the price.

    I’m not complaining. We are fortunate that we had access to sound financial planning advice, which we followed.

    I guess my point is that there is so much that is broken in our country and I don’t have any answers. But, I’m not giving up and I refuse to let them beat me down.

    In that vein, I will be participating in the Women’s 1/21 March on Chicago. There are marches being held in many of the major cities with the main march being held in Washington DC. I also put my representative (Peter Roskam)on my contact list on my phone. I’ve been calling his office regularly, just to voice my concerns about what’s going on in government. Time to get involved. That’s my plan. And, I hope some of your readers will join me.

    Sorry this was so long.

    • Historian
      Posted January 14, 2017 at 8:45 pm | Permalink

      I am afraid you are not going to get much help from your Republican congressman, Peter Roskam. I just glanced at his website on which he bragged that he just voted against the ACA with the standard Republican promise of some great replacement some time in the future.

      • Nancy Holst
        Posted January 15, 2017 at 8:15 am | Permalink

        Well Historian, I guess that means we are going to have to replace Roskam. I didn’t even know he was my representative here in Kane County. Now I do and I’m going to spend as much time and energy bringing him to the attention of others. I’ve never been terribly political in my life but that’s going to change. Dems have to concentrate on change at the local level. So, here we go……

        • Historian
          Posted January 15, 2017 at 8:58 am | Permalink

          You are quite right that the Democrats need to concentrate on change at the local level. The Democratic failure to do this is why the Party is in such a mess. At least in Illinois the Democrats control the legislature and are able to keep under control Tea Party Republican governor Bruce Rauner. House Speaker Michael Madigan may be viewed as a party boss, but he has served a useful purpose despite the sickening lamentations of the Chicago Tribune.

  29. ThyroidPlanet
    Posted January 14, 2017 at 6:53 pm | Permalink

    I’m not thinking of them as Republicans anymore – it gives them too much credibility.

    Other … ideas, are they? … more like stun-words?… of these democratic imposters are “nothing is free”, “all you have to do is work hard.”, “money makes the world go ’round”, “it’s unfair for us to pay for other people to get free stuff”… there are others. I don’t think those are misrepresentative, I think the Imposter party would agree.

  30. rose
    Posted January 15, 2017 at 12:26 am | Permalink

    I have Obama care and its very good. Since it may go away i suppose i have to get a colonoscopy.Really been putting that off. I know its good for me.

  31. Johan Richter
    Posted January 15, 2017 at 4:59 am | Permalink

    A more plausible explanation of Republican opposition to Obamacare is that they don’t like paying for it. Nothing strange or immoral about that. And this is undoubtedly what is driving most voter opposition as well, quite a few people have decided that even with the penalty they don’t think it is worth buying health insurance, and others have bought it but would rather prefer not to, or had better plans before ACA. Many of these people can quite rationally consider them-self worse of with the law.

    To be sure voters are, as always, confused on the issue. They like parts of ACA but don’t like other parts that are necessary to pay for the good parts. I suspect that Obamacare won’t actually be repealed when push comes to shove because pushing people off insurance will be a political disaster.

  32. peepuk
    Posted January 15, 2017 at 5:36 am | Permalink

    There are a lot of countries who have much better and cheaper healthcare.

    https://epianalysis.wordpress.com/2012/07/18/usversuseurope/

    Maybe US-citizens don’t know the facts?

    • infiniteimprobabilit
      Posted January 15, 2017 at 6:03 am | Permalink

      They don’t *want* to know. That would suggest that ‘socialism’ can do some things better than Free Enterprise, which is anathema.

      cr

  33. reasonshark
    Posted January 15, 2017 at 7:39 am | Permalink

    “Some of you may poo-poo the second reason, but over the years Republicans have shown a persistent callousness toward the poor, adhering as they do to a “just world” theory that the poor deserve what they get. But as determinists we know that isn’t true: poor people are the victims of their genes and environments, not poor “choices”. This is one reason why determinism needs to be embraced by people (especially Republicans), for it breeds more empathy towards the dispossessed.”

    The very notion of deserving anything is vacuous. Everything about a person, what they have and what they don’t have, is a result of sheer historical contingency. The only difference between the “deserving good” and the “undeserving bad” is what the lottery of life coughed up for them. It would be tantamount to assigning virtue to the random fluctuations of molecules.

    In addition, it’s confusing two entirely separate issues: an efficient social system, and a moral foundation for said system. People who talk about the “feckless poor” should just admit they want to maximize utterly impersonal and amoral economic utility. They’re treating other people as tools, society as a machine that caters to them. And the bits that don’t work get thrown out as waste.

    That’s not to say that viewpoint’s automatically – or at least, entirely – wrong. Society is, to some extent, a machine, and other people are, to some extent, tools to each other. The human being behind the shop counter – whatever their other virtues as a human being – is basically a fleshy vending machine.

    But in that case, they should have the courage of their convictions and say that this isn’t an issue of morality, but purely of economic utility. Instead, they dress it up in moralistic mythology, because anyone who admitted what they were doing would be denounced as calculating and heartless, however unfairly.

    Nope. Instead, the result is bad economics and bad morality.

    • reasonshark
      Posted January 15, 2017 at 8:03 am | Permalink

      I should clarify that the distinction I’m making is between a pragmatic approach and a moralistic one. The former would say, “OK, we’re trying to find the best way to allocate resources, and unfortunately the trade-offs involved show that we gotta shaft a few people for the good of everyone else in the whole system.” The latter would say, “We’re giving them the shaft because they don’t ‘deserve’ it. They’re fundamentally bad souls. Look how depraved they are. You wanna give them anything? What kind of moral idiot are you?”

  34. Pliny the in Between
    Posted January 15, 2017 at 10:27 am | Permalink

    Best plan to reform US healthcare: Require Congress to be covered by the plan.

    • GBJames
      Posted January 15, 2017 at 11:57 am | Permalink

      You see that idea all over. But I don’t think it really works. Far too many members of Congress are excessively wealthy and really don’t care that much.

      Then there the point that Congress would need to impose such restrictions on its own members. But that’s a separate matter.

      • Pliny the in Between
        Posted January 15, 2017 at 5:30 pm | Permalink

        True of some but certainly not all.

  35. jeffery
    Posted January 15, 2017 at 11:19 am | Permalink

    My answer to the question of, “What are the Republicans going to replace Obamacare with?” is a simple one: having had years in which to come up with something (to replace a plan that was a Republican one to begin with)), they don’t have squat- it’s entirely obvious that they DON’T want to replace it with anything (it’s kind of like the question, “Why isn’t there peace in the Middle East?”- because powerful entities don’t WANT it). Hard-core conservatives have always been against the Federal government’s giving anyone ANYTHING (it’s “socialism” to them; the taking of someone’s money and giving it to someone else); they want a return to their dog-eat-dog, every man for himself, “just world” that Jerry mentioned. It never seems to occur to these people that poor people who can’t afford health insurance will simply go to the ER, the bills for which we will still have to cover, either as taxpayers or as the result of higher insurance premiums- or maybe it does occur to them and this is just another example of their total indifference as to the welfare of anyone other than the wealthy.
    Now they’re in a challenging situation: they know the political fall-out that they will incur by NOT replacing it, but they are loath to not utilize this opportunity to get rid of a part of “big government”- I suspect we’ll see a lot of stalling and shilly-shallying around while they try to figure out how to do it and still maintain their grip on power.

  36. Diana MacPherson
    Posted January 15, 2017 at 11:50 am | Permalink

    I feel badly for the world but I feel very badly about the ACA being repealed. I met a woman on FB who is in hospice with stage IV breast cancer. She is on a lot of pain medication and can’t work because of exhaustion and pain. If she loses coverage, she could have to work again. Can you imagine that? A person with in hospice having to work? It’s barbaric!

  37. Diana MacPherson
    Posted January 15, 2017 at 4:56 pm | Permalink

    I like Affleck’s acting too. It’s unfortunate he was such a dick to Sam Harris in Real Time because it affects how I feel when I see him.

  38. Posted January 15, 2017 at 5:36 pm | Permalink

    The Republicans don’t hate the poor people. They just LOVE the rich people, and will not let anyone or anything to stand in the way of happiness of the rich people.

  39. Posted January 16, 2017 at 12:01 pm | Permalink

    Plutocrats and Theocratic Plutocrats …

  40. Posted January 21, 2017 at 4:08 pm | Permalink

    A significant portion of the discussion about repealing the ACA revolves around the poor and excludes a appropriate discussion of the elderly on Medicare.

    In addition to patients, I’m sure physician providers and health care systems are waiting with baited breath to see how their daily life may be impacted by the decisions of the new administration.

    I’ve recently started a new blog on Pharma, healthcare, and technology. Would love for you to join in on the discussion!


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