Rand Paul

Sen. Rand Paul Introduces Replacement for Obamacare

Paul's bill equalizes tax deductibility on insurance whether obtained through employer or not, makes creating private group insurance easier, relies on Health Savings Accounts.

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Sen. Rand Paul (R-Ky.) today introduced his comprehensive plan to replace Obamacare after the Republicans, as they claim they intend to, fully repeal it.

Reason

Paul calls it the "Obamacare Replacement Act" (S. 222), naturally. Among its key provisions:

• 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 those within the group market could obtain continuous health coverage regardless of preexisting conditions.

That's to cover those who worry about mass insurance deprivation without Obamacare. But interesting market innovations are in the bill to change the game as well:

• Replaces the existing open-ended tax exclusion for employer-provided health insurance with a universal deduction on both income and payroll taxes that would provide the same level of benefit regardless of how an individual obtains their health insurance.

Paul lamented in a conference call for media introducing the bill this afternoon that some were interpreting this as eliminating the employee tax deduction; it is not, merely extending it to individuals paying for their own as individuals or in a market-formed group.

The bill will also give "individuals the option of a tax credit of up to $5,000 per taxpayer for contributions to an HSA…. Removes the maximum allowable annual contribution, so that individuals may make unlimited contributions to an HSA….[and] Eliminates the requirement that a participant in an HSA be enrolled in a high deductible health care plan."

The full bill summary has many other details on the HSA plan, who can use it and how and for what, and its tax treatment.

Paul's bill also wants to make it easier for individuals "to pool together for the purposes of purchasing insurance" and thus "Amends the Public Health Service Act (PHSA) to allow individuals to pool together to provide for health benefits coverage through Individual Health Pools (IHPs). These can include nonprofit organizations (including churches, alumni associations, trade associations, other civic groups, or entities formed strictly for establishing an IHP) so long as the organization does not condition membership on any health status-related factor."

Paul's plan also "Increases access to individual health coverage by allowing insurers licensed to sell policies in one state to offer them to residents of any other state" with certain wrinkles explained at length in the full bill summary from Paul's office.

The bill also rejiggers the law surrounding:

Association Health Plans (AHPs) [which] allow small businesses to pool together across state lines through their membership in a trade or professional association to purchase health coverage for their employees and their families. AHPs increase the bargaining power, leverage discounts, and provide administrative efficiencies to small businesses while freeing them from state benefit mandates.

While AHPs currently exist, strict Department of Labor standards exist regarding the types of organizations that may qualify as a single large-group health plan under ERISA. The standard stipulates that the association must be a group of employers bound together by a commonality of interest (aside from providing a health plan) with vested control of the association to such an extent that they effectively operate as one employer. This is considered a difficult standard for most associations to meet.

[So Paul's bill] Amends ERISA to define AHPs and allow for their treatment as if they were large group single employer health plans. This definition would allow a dues-collecting organization maintained in good faith for a purpose other than providing health insurance to benefit from the insurance regulation exclusions currently afforded to large-group health plans under ERISA.

Paul also wants through the bill to "give new flexibilities to states in their Medicaid plan design, through existing waiver authority in current law….[to] allow states to make changes to their Medicaid plans without interference from Washington."

In a conference call this afternoon to introduce the bill, Paul said he believes that at least generically he's got Speaker of the House Paul Ryan (R-Wisc.) and Senate majority leader Mitch McConnell (R-Ky.) on board on the notion that a full replacement must happen simultaneous with repeal.

He believes his plan has "consensus ideas that 100 percent of Republicans in the House and Senate can embrace" and that they then can "take to Democrats to see if Democrats in favor of trying to replace a broken system" will also hop on board.

Paul says he finds an alternate replacement bill from Sens. Collins (Maine) and Cassidy (La.) lacking, mostly because it allows too much of Obamacare to potentially survive on the state level. He says he believes ultimately the best way to deal with very sick people with pre-existing conditions will lie with Medicaid and the states who can "look for innovative ways" to provide necessary care without bankrupting the system.

As far as the process goes, Paul says he does not expect a real repeal vote for at least two weeks. In the meantime, he says he is "pushing hard" his bill, which he's "sent to leaders in the House working on the issue, discussed it with leaders in the Senate."

He's "trying to emphasize that this bill has the potential to insure millions at cheaper cost than under Obamacare and has great ability to straighten out the mess in the individual markets."

Other media noting this announcement today include Business Insider and Rare.

Peter Suderman reported earlier this month on Paul's reluctance to repeal without a comprehensive replacement plan ready.

UPDATE: For those wanting more legislative details than the 4-page summary released yesterday and linked above, here are all 149 pages of legislative language.

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425 responses to “Sen. Rand Paul Introduces Replacement for Obamacare

  1. Will it do away with the mandate and the absurdly over-featured plans required by ObamaCare?

    1. But I need you to pay for my birth control.

      1. We’ve been over this, pepper spray is not birth control even though the effect is the same. Also, you should find nicer women to “court”. Making you pay for the pepper spray they use on you? Not cool.

        1. It’s like you’ve never seen Under Seige 2.

          1. That was before Seagal got fat. His current look is his birth control plan.

            1. I use “fecal facials” as birth control, and it works quite well! The cost is rock-bottom low, too! Let’s just get Trump-care to approve this as the one-and-only fully-paid-for method, and move ON!!!

        2. “pepper spray is not birth control”

          STEVE SMITH BEG TO DIFFER

          1. I thought it was an aphrodisiac for STEVE SMITH.

            1. It is just one tool STEVE SMITH uses to stay in control at all points of the birthing process.

              1. From before conception to after delivery.

      2. I think we’d all chip in to prevent Crusty from procreating.

        1. I thought premature ejaculation was Crusty’s version of natural family planning.

    2. My understanding is that it’s meant to be coupled with a full repeal, so yes.

      What it will look like once the political sausage-making process is done with it is anyone’s guess.

      1. That’s what I am worried about as well. However, his proposals are awesome. Especially decoupling health insurance from the employer and eliminating the cap on HSA contributions. Go Rand!

    3. You have to pass it to find out what’s in it.

      1. . . . then it has Nancy Pelosi’s vote?

    4. My first question as well. I don’t need mental health, substance abuse, chiropractic, homeopathy, acupuncture or OB/GYN coverage.

      so long as the organization does not condition membership on any health status-related factor.”

      Too bad about this provision. I’d like to join a pool of healthy males who don’t go to the doctor unless they’re injured or ill to the degree that they’ll think “fuck, I guess I have to go to the Dr., Goddamn it ! Screen out anyone who answers “yes” to “are you taking any prescription drugs right now”?

      No hypochondriacs, malingerers, or pussies need apply.

      1. So I’m thinking the plan offered through the International Triathlete’s Association will be good, no?

        1. I’m thinking small farmers who haven’t seen a doctor. since the maternity ward or the military, maybe they stitched a laceration up with sewing thread once or asked the large animal veterinarian how much cow antibiotic to administer for an animal “about my weight”.

          1. Uhhhhh, you might want rethink that. Cancer incidence among farmers is pretty high.

              1. I figured their death rate would match the general populations rate of 100%. But if some are immortal then I want in on this gig too.

                1. Good point. (note the source is a .gov site)

                  I have met nonagerian and even centenarian active farmers. Maybe they were actually much older

                2. Actually, an estimated 6.5% of all the people who have ever been born are alive today, so the death rate is 93.5%. I plan to remain in the 6.5%. Forever.

                  1. I too plan to live forever. So far, so good.

                3. For immortals, are unintended side effects of dark quickening scenes covered?

            1. I’d prefer a pool of people who avoid “healthcare” because, aside from the their low utilization rate, I ascribe to an iatrogenic theory of disease.

          2. I remember seeing a documentary on TLC about a farmer who fell on his dick and sprained it or something, then waited to go to the doctor until it had turned black and they had to cut it off.

            Was that you SIV? Have you been fucking those chickens with a strapon all these year?

        2. So I’m thinking the plan offered through the International Triathlete’s Association will be good, no?

          Umm, no:

          http://www.thedailybeast.com/a…..tions.html

          Not to mention all the orthopedic issues.

      2. My first question as well. I don’t need mental health, substance abuse, chiropractic, homeopathy, acupuncture or OB/GYN coverage and cloaca reconstructive surgery coverage.

        FTFY

        1. Aaaand I just googled “cloaca” thanks

      3. That isnt very forward looking SIV. The group you describe would only last a few years.

      4. What kind of coverage do you think athletic types with a pre-x condition should expect?

      5. Um, you might wish you had mental health coverage at some future date and if aren’t covered now you won’t be covered then.

        Especially if there are any females in your future household.

      6. “I don’t need mental health, substance abuse, chiropractic, homeopathy, acupuncture or OB/GYN coverage.”

        So, you won the genetic lottery (lucked out an wasn’t born female, nor with schizophrenia, nor with any condition which, for some crazy reason, only seems to be relieved by less-conventional treatment), and, now, you don’t see the point in pitching in to help all of those people who made… oh, what’s that phrase… oh, “poor life choices”… where “poor life choices” means “having the poor judgement to be born female or to parents with crappy genes”.

        1. Not even gonna swing at the obvious troll.

      7. Keep your socialist hands off of my aromatherapy and cosmically-aligned magnets!!!!!!!

  2. I have tremendous respect for anyone that actually has their mind wrapped around the “big picture” of what a fucking mess the funding side of the US healthcare system really is. The alphabet soup of different acronyms makes my eyes glaze over almost as much as the myriad of arbitrary calculation rules on most IRS forms.

    1. Same here but I was able to follow it enough to see that it is a pretty serious move to a freer market.

      1. I disagree. He says he believes ultimately the best way to deal with very sick people with pre-existing conditions will lie with Medicaid and the states who can “look for innovative ways”

        Basically what he is saying is – if the govt is responsible for all the big expenses, then the free market can look like its controlling expenses for healthy people who don’t incur and don’t need much.

        Just another way of avoiding the difficult in order to get credit for what isn’t.

        1. Roughly how many people have pre-existing conditions?

    2. Recommend John Goodman’s “Priceless”. The most readable overview of this message I’ve ever seen.

      1. “message” = “mess”. Autocorrect …

      2. Seconded. Goodman’s other book is good too, the one he wrote in 2012 I think. He also writes articles for the Independent Institute that are well worth reading.

      3. i loved him in ‘the big lebowski’.

        1. This is what happens when you fuck a stranger in the ass!

  3. Whatever you do, Rand, don’t say anything like “wither on the vine” in relation to people leaving the old Soviet-style progrom… program… I mean program.

    1. It’s spelled pogrom, wrecker.

      1. He’s not your wrecker, kulak.

        1. He’s not your kulak, Uzbek.

  4. I would be very surprised if more than a handful of Dems sign on and not surprised if none at all do.

    The Dems want single payer. A healthcare system that works and isn’t single payer is unacceptable to them.

    1. Oh, and Rand *headsmacks Sen Paul* change the damned name.

      1. Take a page from the Dems and just insist that his bill IS single-payer and anyone who says it isn’t is racist.

        1. So, maybe, “The Single Payer and If You Oppose It You’re a Racist Who Hates Women and Puppies Act”?

          1. I would add ‘looks at trannies cross-eyed’ to the title.

      2. Yeah I suppose “The Obamacare Sucks Act” is too honest

        1. Nonsense. Were it honest it would be “Obamacare sucks suppurating moose dong”

      3. Second. How about a positive spin? Like “Free to Unfettered Care Act” (FUCA).

        1. The “For Universal Caring and Kindess” Act.

          1. ‘The Read It Before We Pass It Without Being A Bag of Dicks About It Act’

            1. That’s a nifty acronym.

    2. If they wanted single payer, why didn’t they do that when they had the presidency, senate, and house?

      1. They looked out the window at the sea of pitchforks. They decided to move incrementally.

        1. Hell, Suthen, I like your answer better.

        2. Or maybe they knew that if they did it up entirely alone and rammed it through then they’d have to answer for all of its failings themselves.

          This way they can pretend that the Republicans did a bunch of hinky stuff to it and that’s why it doesn’t work.

          If you’re going to rob a bank, always have a getaway car with the motor running and an escape plan.

          1. If you’re going to rob a bank, always have a getaway car with the motor running and an escape plan.

            You’ve been listening to Mississippi Gary. “You shouldn’t use your tongue to stop a fan, you shouldn’t rob a bank without a plan.”

            1. I’ve never seen that, but there’s some folksy wisdom there. 😉

              1. Some of those Canadians are crafty folk…

          2. Or maybe they knew that if they did it up entirely alone and rammed it through then they’d have to answer for all of its failings themselves.

            They did do it up entirely alone; not a single Republican voted for it.

            Of course, that doesn’t mean they didn’t try to blame Republican obstructionism for its failings anyway…

        3. Exactly. Even to get it passed in its current atrocious form, they had to bribe some Senators and twist every arm they could find. And even with that, it had to be passed in the middle of the night on Christmas Eve. Even the fools who voted for it knew Obamacare was toxic. They were just hoping they would be able to get around getting caught.

          1. They literally did bribe a blue dog Dem senator (I think; I don’t think it was a congressman) from West Virginia with special federal aid to pay for WV’s medicaid expansion in order to get him in line behind it.

          2. One thing the left is good at is incrementalism. The left could not get single payer due to the sea of torches and pitchforks and the likely bloodbath at the ballot box. Obamacare, while doomed to failure, would at least get enough additional people dependent on government to perhaps open a window for single payer under a Clinton presidency. Clinton’s defeat spoiled the plan. But even now there are so many people newly dependent on Obamacare that the republicans can not simply repeal it.

      2. Because the public was not yet “enlightened” enough to accept it?

      3. I partially disagree with Suthenboy here. The Democratic Party isn’t as ideologically monolithic as it’s sometimes made out to be on the right, and this was more true in 2008-2010 than today.

        The Bernie faction is definitely insistent on single payer the way he describes. A less radical wing of the party is open to other forms of UHC, such as the public option and multipayer models developed in many other countries (not every country that has UHC has single payer). And the most moderate faction was against the public option, but in favor of other ways of the government increasing insurance coverage. This last group was essentially the Blue Dogs and doesn’t really exist any more, but there were enough of them in Congress back then that Obamacare was the best the Democrats could get past despite their large majorities in both houses.

        1. Given my limited understanding I will concede.

          I still love the vision of a sea of pitchforks on the mall.

          1. *Goes crowd surfing*

            1. Ow ow ow ow ow ow ow ouch

              1. You know what? That was funny. Screw you people.

                1. We get the point

        2. We haven’t had moderate, much less conservative Democrats in the Congress this century. What you had was a very few representing districts/sates where they’d get voted out if they supported really liberal shit. Remember Kirsten Gillebrand? She represented a relatively conservative upstate district and had like a “B” from the NRA. She became a Senator from NY and now she’s hard left.

          1. Indeed, funding flows from the top down, from the DNC and it’s big funders. The higher up you get, the more dependent you are on them for resources necessary to win re-election, and the more you have to tow the party line. That’s why there are in fact still plenty of conservative Dems (or to some extent progressive Republicans) at the local level, but once they get to the national level, they adopt the party platform.

        3. not every country that has UHC has single payer

          Just FYI, there are only three truly single-payer systems on the planet: Canada, Cuba, and North Korea.

          1. NHS? Or are you saying that doesn’t qualify because you can still buy private care? In that case strike Canada as well.

            1. Single payer is when the doctors are basically privately employed and the government provides reimbursement for services. Much like medicare or medicaid. The NHS (like the VA system) is socialized, in that the doctors are employees of the NHS and don’t bill for individual services.

              1. No.

                1. No?

        4. “I partially disagree with Suthenboy here. ”

          No way!!!

          Not YOU!?!?!?!

      4. They believed people didn’t want single payer, and they could win with the ACA, then blame insurance companies when it went to shit?

  5. That’s a real Bill Murray pose that Rand is taking. Was it Bill that did the photo shoot?

  6. Hopefully this coupled with a decent FDA head..

    1. By decent I mean, someone like Thiels buddy who will destroy it.

      1. Or maybe make it a certifying agency for (a) pediatric drugs and (b) drugs for people who care what the federal government thinks about their drugs.

    2. Some libertarian guy was rumored a while back to be considered, and the leftists in the media slammed him because he wanted to make it so that any drug proven to be safe could be marketed, rather than requiring the drug to surpass the standard of care.

      I remember thinking that it was basically article #56465753 of evidence that leftists are retarded, and will oppose anything just because it’s associated with Trump. This reform should be completely non-controversial. Just because a drug isn’t as good as the best drug out there among the few dozen people in the clinical trial doesn’t mean it should be shelved indefinitely. Let it go to market and it’s very likely it will be discovered that it works better among specific subsets of patients than the standard of care, because people are, like, heterogeneous, hard as that is for proggies to believe.

      But yeah, loosening regulations on pharmaceuticals and medical technology and occupational licensing in medical professions the way to go if health care prices are ever to be brought down significantly.

      1. What is not known to most is that the effect of any drug varies according to your DNA. The cholesterol drug that works on me will not work on my wife. The only one that works on her is Lipitor. I’m allergic to penicillin, she isn’t. So regardless of what tests the FDA runs, there is no way of accurately know what the effect will be on any individual. Age, lifestyle, male or female, almost everything comes into play. Side effects also vary by dosage. The interactions between any two drugs is also a consideration.

        For all practical purposes medicine even today is far from being an exact science. This is also why the concept of medical malpractice as defined today is seriously flawed. A drug given at a lower dosage may produce a different effect upon the patient at a higher dosage. A good example of this is Tylenol. Safe to use at a certain dosage, but can be fatal at a higher dosage over a period of time. Plus your doctor is unlikely to be aware of all the possible effects of a medication which can vary according to an individual’s DNA.

        Something to think about when discussing the issue of health care.

    3. I have been hoping that someone in Congress or from Trumpo’s staff would revist Abigail Alliance v. Von Eschenbach. You might remember it as the case where the DC Circuit court said dying people have no right to potentially lifesaving experimental drugs. I believe the SC declined the hear it after that.

      1. The repeal of prescription laws, drug laws in general, would solve this issue. Of course we need to have a national government that believes in personal freedom and does not view those living under it to be it’s “subjects”.

  7. Anything to take the shine off Obama and the Democrats for having passed the bill the way they did. They deserve it.

    Will it drop the penalties/fines?

    That’s the part that would grate me.

  8. Rand Paul is the only sane person in the entire government. Actually he is well-positioned to be very influential in the Trump regime. Libertarians are despised – meaning that Trump is likely to turn to him for advice and direction in the hopes of pissing everyone off.

    “We’ll give up single payer if you give up waterboarding.” Whaddaya say??

    1. *puts check mark on calendar*
      Yup, dumbass on Wednesdays, too

  9. It would be nice if the journalists here were kind enough to summarize the entire thing, doncha’ think?

      1. Goddamn. That’s pretty good. I knew I liked that boy.

        1. “Pretty” good? It’s f***ing awesome!

      2. Looks great.

      3. And in all of 4 pages! In language most adults can understand!
        Pelosi is going to be pissed at knowing what’s in it before it passes.

        1. With no numbers. What about guaranteed issue? What pays for those additional tax credits–is it a reduction in credits for employer provided plans? Not nearly enough information on those 4 pages.

      4. Thanks — there’s some fine stuff there, at least for a government program. Too much to hope for just get out of the way, but this is so much better than anything before Obamacare, let alone Obamacare itself.

        Too bad Congress will fuck it up. The Dems will do their damnedest to load it up with crap, the other Republicans will do their damnedest to load it up with different crap.

        1. This would be a much better country if we could get rid of political parties along with political candidates who “sell” themselves to the highest bidder. Too bad the “Founding Fathers” favored Rome over Greece.

          The Greeks of Classical Athens did solve this problem. Representatives were selected by lot from among the citizens of the city-state. No political parties, the people who have become representatives represent a true cross section of the entire citizenry. Of course those who sought political power to enrich themselves were totally opposed to the idea. The licensed professions and occupations would also hate the idea that they no longer could enjoy the profitable legal monopoly that they have managed to “purchase” from the government.

  10. The bill will also give “individuals the option of a tax credit of up to $5,000 per taxpayer for contributions to an HSA…. Removes the maximum allowable annual contribution, so that individuals may make unlimited contributions to an HSA….[and] Eliminates the requirement that a participant in an HSA be enrolled in a high deductible health care plan.”

    Once you pass the $5000 tax credit, why would you want to donate more to an HSA instead of putting it in a standard investment account?

    1. HSA capital gains are not taxed.

      1. Ah, okay that makes sense then.

    2. I see no reason why Health Savings Accounts can’t be in the form of investments that earn meaningful interest. Vanguard’s two bond index funds according to their data seem to double in value over a decade of time. Note however that no allowance is made for inflation, so the actual “return” is likely more in the 5% a year range. Still a heck of a lot better than the one tenth of one percent interest my bank is willing to pay on deposits.

  11. Hot damn, this actually looks pretty decent. Nice job, Rand.

  12. Wow, man. This is like my wish list of what health care in the US ought to be like. The uncapped HSA coupled with extending the tax deduction to individuals is absolutely key to beginning to solve issues of cost and access. And then Medicaid/Medicare acts as what they’re supposed to be: safety nets for the truly indigent.

    1. Yeah, there’s clearly a good deal of CATO in this proposal. He’s done his homework. Good stuff.

    2. This is like my wish list of what health care in the US ought to be like.

      So, not a free market?

      1. Sure, it’s not a pure anarcho-capitalist healthcare plan, but it’s taking healthcare in a more libertarian, market-oriented direction. It’s a baby step. That’s the only way that positive changes can ever stand a chance of getting done. It gives people a chance to see that a free-er market can lead to better outcomes.

        I’m on board with the idea that a stateless society should be the goal. But I also believe that when the government is so heavily intertwined with a certain industry, it’s going to be pandemonium if they were to suddenly scrap the entire set of relevant laws and subsidies. The adjustments to the new state of things would take time, and meanwhile, people would start yearning for some kind of socialist idiocy just to “get things under control”.

        It’s better to slowly move in a pro-market direction and let these adjustments happen gradually.

  13. “Rejiggers?” RACIST!

    1. Jigga please

  14. A good plan violently executed now is better than a perfect plan violently executed next week, but a perfect plan sometime off in the indefinite future is how you get re-elected.

  15. How about: first, amend the Constitution.

    If a supermajority of states is, in fact, in favor of national socialized medicine, there’s a right way and a wrong way to do it.

    This is the wrong way.

    1. You kidding? Colorado tried to create a socialized medicine scheme in this last election and its voters slapped that thing down hard. Americans don’t want a government take-over of healthcare.

      A Constitutional convention to amend it for that is just not going to happen.

      1. Don’t need a CC to amend. Congress (maybe just house?) sends to states for ratification. All amendments since the first 10 were passed this way.

        1. I was being a bit hyperbolic there. It’s going to require lifting a mountain to get an Amendment was my only real point.

          Also, Congress has learned its lesson about not putting expiration dates on Amendments ever since the 27th Amendment rose like a specter from what had appeared to be a grave to haunt Congress.

      2. Really bad idea.

        A constitutional convention would take years to implement and then loose.

        Change to the constitution is not to be toyed with.

      3. Shit, not even fucking Vermont could make single-payer work.

        1. My friends back home blame the Republicans in the state house for that. And something about not going far enough, or investing something…

          1. This is what happens when you don’t spend enough of other people’s money. Ok, I made that up, but I was trying to help them be a little more original as an excuse for running out of other people’s money.

            1. It’s just insanely stupid. The dems passed it and then the dem governor said we couldn’t ever afford it unless we taxed business into the ground.
              And they hear that and think “why not?!”

      4. The problem is that when considering a single payer system, no one is prepared to actually reduce the cost of health care here in the US. On a per capita basis, our health care costs are currently approaching $10,000 per capita per year. Our total health care costs now exceed three trillion dollars a year. Many people, especially those who have employer paid insurance, aren’t aware of what the true cost of their health care is. To pay the cost of US health care through taxes would probably double what most people pay at least. The most common method of financing health care in the rest of the developed world is through value added taxes. Effectively a sales tax.

        However these countries don’t allow their medical providers to charge whatever they want. This is why the UK in 2015 only spent 7.7% of its GDP on health care. Germany spent 9.8%. The US spent 18%. There’s the problem. There is also the issue that a doctor in some European countries pays nothing for their education. Here in the US a new doctor may owe as much as a quarter of a million dollars in student loans. You can guess what the monthly payment on such a loan would be! That’s part of the problem we face.

  16. Charity Care and Bad Debt Deduction for Physicians
    ?? 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. This deduction is limited to 10% of a physician’s gross income for the taxable year.

    *sets rates for all procedures to twice the market rate, but gives every patient a 50% charity discount*

    1. “…would otherwise charge…”

      This language would be an issue.

      1. Maybe replace that with “the market rate”?

    2. Not much different than how Medicare distorts book rates at hospitals currently.

    3. That was my line of thought when I read this.

      [Health insurers] emphasize that it is crucial to keep government subsidies for low income people.

  17. If we get to refer to it as Randycare, then I’m all for it.

    1. Oh, I like that.

    2. Kelly Rand will veto that idea. But how about AquaBuddhaCare?

      1. Winner.

  18. Purchase of Health Insurance from HSA Account
    o Currently, HSA funds may not be used to purchase insurance or cover the cost of
    premiums. Allowing the use of HSA funds for insurance premiums will help make health
    coverage more affordable for American families.

    Would this applies to things like Long Term Care coverage?

    1. Unfortunately, the text is not online yet. The bill just has a placeholder page on congress.gov for now.

      1. I’m just asking, because my LTC is getting hella-expensive, so paying with pre-tax dollars would be nice.

  19. Some more catchy jihad songs

    I imagined the lion saying “Allahu akbar” into the microphone in the voice of Tony the Tiger.

  20. just imagine if we had had ideas like this, or the one Tom Price has talked about, or others instead of that shit show that led to the passage of O-care. But then, that would require debate and the possibility – hell, the likelihood – that Dems and Pubs might agree on some things and think how much that screw fundraising.

  21. I am quite surprised that Rand suddenly finds himself with perhaps more influence, at least in certain areas, under Trump.

    I wonder if that will last when it Trump starts to push his surveillance state and torture programs. If Paul hasn’t been bought off. If he manages to get this through, he’d be a legend.

    1. I think Trump has sowed a great deal chaos into the ranks of the GOP officials, so it’s not entirely clear who is in charge any more, especially since the leadership have a (at best) tense relationship with their president. That basically makes it a good atmosphere for up-and-comers to take the initiative and establish themselves as leaders. Rand seems to be taking advantage of that.

  22. Wow! It’s almost as if he has some personal experience with healthcare!

    1. Wow! It’s almost as if he has some personal experience with healthcare!

      Like his father before him, BP?

      1. Did the Democrats seek any input from actual physicians, or did they just let the lawyers have at it? Because why would you need anyone but lawyers?

        1. Tom Price, incoming (likely) HHS Secy, is a doctor. But he’s a Pub, so the answer must be no. It’s not like Price was/is the only doc in Congress.

        2. I believe Ezekiel Emanuel, for one, was involved.

        3. Don’t ask doctors how to set up an insurance market, you won’t like the answer.

          1. Fair enough, but designing a medical system w/o medical input is a bad idea.

            1. BP,

              Wow! It’s almost as if he has some personal experience with healthcare!

              Both Representative Ron Paul and his son Senator Rand Paul seem to be accomplished doctors.

              Do you agree?

              1. Skip this, if you are sufficiently inclined.

          2. +1 Blue Shield

        4. I seem to recall Obama on the white house lawn with a bunch of smiling actors in lab coats and stethoscopes around their necks. The whole spectacle was so creepy and cheesy it made old-timey used car salesmen look honest, suave and sophisticated.

        5. I would think that lawyers are the recipient of so many health care dollars that they probably could be qualified as health care experts. Just watch TV for an hour and you will probably see an ad like this: “Did you take this drug and stub your toe? Call 1-800-SHYSTER. You could receive a large settlement.”

  23. Hitler’s Grave Miscalculation at the Bulge
    You know who else made a grave error at the Bu… Oh…. Wait… Nevermind.

    1. Was it the inability to post a working link?

      1. Damn your and Chucky’s nimble fingers!

      2. Huh. Wonder how that happened. Squirrels?

    2. You.

    3. Denver J? At least, he made a grave error linking about the Bulge.

    4. Did you miscalculate also ?

    5. The guy who sells William Shatner his trusses?

    6. I once made a grave miscalculation with my Bulge.

      1. Tell me more about your hemorrhoid. Does it bleed? Does it throb?

        1. As far as I recall, there is not a single reference anywhere in the SugarFree canon of your fetish for hemorrhoids.

        2. A Warty appearance! Like Sasquatch sighting anymore.

      2. You and every other dude in the universe.

      3. We’ve all done that.

    7. First Lieutenant Norman Dike.

    8. Ben Stiller in “There’s Something About Mary”?

        1. Well, how the hell’d you get the beans above the frank?!?

    9. Did someone post that here earlier today? If not, how is it that I wound up reading that same story today?

  24. This seems less terrible than any of the options that are possible, doesn’t it?

    1. So, it never makes it out of committee or is unrecognizable if it does?

  25. I say pass it quick, so we can find out what’s in it.

  26. Rand “Mutha Fucking” Paul!

    1. One thing libertarians can be happy about is that with this administration Paul is going to have many opportunities to be “the adult in the room” and he’s armed with answers that we all know will work if they’re tried.

      He will be demonized and cursed by the Grey Lady and others but the results will be hard to ignore.

      Show me a low deductible -high limit HSA account plan with basic coverage and you’ve already saved millions of people several hundred million, if not more. That shows up in the monthly budget fast.

    1. And then the government stepped in and took over all of the protection rackets

      1. That’s a nice republic you’ve got there. Would be a real shame if something were to happen to it.

    2. Is this similar to Crusty’s protection concept of jizonya?

      1. How many times are you going to let him trick you with that?

        1. But he swore it was the only way to protect me from his psychotic chinchilla roommate.

    3. Not buying it. Why would the mob have to learn from Arabs what every government in human history had already taught us?

      I think intellectuals today so fundamentally misunderstand why governments existed in the past that this concept would be foreign to them.

      1. What I *do* find fascinating is why it evolved the way it did in Italy in the backdrop of the Catholic Church, the city-states framework, its Kingdoms and Empires (after Rome i.e. Genoa and Venice) etc.

        1. I find that fascinating but also completely expected considering Christians spent untold fortunes protecting Crusade routes.

          Interesting? meh.

    4. Heard that theory over the years. Probably has some truth to it. But not sure about the assertion Arabs influenced Sicily more than any other culture. We’re talking about an island that has seen dozens upon dozens of cultures for thousands of years from the Sicani to the Phoenicians (who founded Syracuse) to the North Africans to the Greeks, Romans to the Normans and various Germanic tribes. Shit, some of their dishes are mysterious. Almost impossible to trace things there.

      1. “Almost impossible to trace things there.”

        Like people who run their mouths too much, capice?

        /stereotypical Sicilian mobster

        1. Calabrese make Sicilians look like pikers where Omert? is concerned.

          1. Yeah, but ‘Ndragheta is so much harder to pronounce than Cosa Nostra.

            1. *Ndrangheta

              See what I’m saying?

    5. ‘Jizya’ I tihnk is actually meant to be a sort of ‘welfare’ type system, perhaps reminiscent of the Catholic tithe. I don’t think Mafiosi really pretend to be redistributing the extortion money they collect to the poor.

      In fact (I may be wrong) but I thought jizya was basically voluntary (perhaps ‘socially compelled’, but not originally state-coerced) charity to the poor.

      But of course, most importantly, it has ‘jiz’ in it.

  27. OT:

    “SF’s Lee stands up to Trump, says city remains a sanctuary”
    http://www.sfgate.com/bayarea/…..883956.php

    That’s ‘stands up to Trump’, like Trump was threatening him with something other than defunding a program which is strictly a local choice.
    And you bet he’s going to ‘stand up to Trump’! When Trump and Co. turn off the faucet, ol’ Ed will nail the local taxpayers! That’ll show Trump!

    1. Come on. We all know that the rich in San Francisco will just have to pay a fairer share.

      1. In Calizuela, everyone is equal, but some are more equal than others.

      2. You think you’re jesting:

        “Can this S.F. supervisor’s CEO tax idea really attack income inequality?”
        […]
        “Details on the proposal are scant, but the ordinance would likely be modeled on a similar plan that was approved by Portland’s City Council last November.”
        http://www.bizjournals.com/san…..ality.html

        CEO moving services stocks gain ground!

        1. That’s one way to drive down property values in SF. Just drive away all the rich people.

    2. Man… it’s like SF is reading NYC’s mind. Or vice versa.

    3. then I guess Trump says “fine, but decisions come with consequences. Have a great day.”

  28. Of course, I know that Reason is going to cover the March for Life in any event, but now they have an extra cause to do so:

    Trump Spokesman: White House Staff Will Attend the March for Life

    1. See, the problem with the people who attend March for Life is that they don’t burn things or attack random people who look like they may support Republicans. It’s like they’re not even trying.

      1. Yes, we have never known pro-lifers to turn to violence.

        1. The vast majority of prolifers disavow the tiny group of violent people who act in the name of their cause.

          Just like the progs vehemently disavow that small, tiny prog subgroup which commits violence, right?

          1. I am pretty sure most progs do disavow violence if you ask them directly. As do most muslims.

            1. Hm…next time there is rioting, turn on CNN. We’ll see how many progs are disavowing anything. Saying you disavow violence while cheering on people committing it is pretty meaningless to me.

              My comment was meant more as a joke. We all know the real reason this is ignored, and it’s simple partisan hackery. But you may object to that, anyway. The cosmos around here may not be progs, but sometimes you cocksuckers make me scratch my head. I say that as someone who doesn’t dip or even own a gun. My yokel creds are pretty damn low.

              1. I probably have more yokel creds than you, lol. I am pretty yokel in many ways, though you would know know from my comments here.

            2. “I am pretty sure most progs do disavow violence”

              Yeah, sure.

              Got any more easily-discredited talking points or attempts at moral equivalence?

                  1. I only read a few comments.

                    There’s hope yet for Salon commenters.

                    They were, thankfully, having none of it.

              1. A.) One doesn’t have to be a prog to gain a sense of satisfaction at seeing Spencer get cold-cocked like Ike on Tina.

                B) Indulging in a bit of schadenfreude doesn’t equal “support of violence”.

                1. The first link (which I first saw on Reason) was by a journalist who took part in the inaugural riots, including burning an immigrant-owned limousine and of course smashing windows.

                  Who gets a “sense of satisfaction” at seeing rioters break windows?

                  1. (C) Consider the broad definition these people have of “nazi” when evaluating their argument that it’s OK to hit nazis.

                    1. Oopsie

                      “…a man was shot in the middle of the raucous anti-Milo demonstration. But no Milo supporters were involved in the altercation.

                      “The person shot was actually an anti-fascist protester, and the non-white shooter attacked him because he thought his victim was a Nazi. The man who suffered a life-threatening gunshot wound voted for Bernie Sanders, has an anti-Nazi tattoo and was at the event to express his disgust for Yiannopoulos.”

                2. “One doesn’t have to be a prog to gain a sense of satisfaction at seeing Spencer get cold-cocked like Ike on Tina.”

                  No, but one *does* have to be somewhat naive about the dangers posed by lefty violence. If one lefty gets away with it and gets cheered or “understood,” others are emboldened to commit more violent crimes.

                  1. Looking at all the examples of “antifascist” violence by the left, the Spencer attack is one of the rare instances where they get an actual fascist.

                    These SJWs aren’t hardened street brawlers, as they would need to be if they made a habit of fighting *real* fascists. Instead, they generally go after university presidents, commuters, windows, controversial gay speakers, regular people trying to attend the Inauguration, etc., etc.

                  2. Yes, anything less than constant Jonathan Edwards-esque stentorian jeremiads against the evils of face-punching will lead this nation into a bloody civil war that will make the 200 years of internecine warfare of Sengoku-era Japan seem like a playground brawl.

                    1. I’m not sure where you’re going with this…there’s a contingent of lefties who really want to sit in judgment of you and I and decide if we’re worthy of being punched, our roadways obstructed, etc. Most of them are lamewads who operate on the assumption they can get away with it…if it’s made clear to them that they’ll be arrested and punished they’ll just go back to calling people nazis on Twitter. But if their activities are winked at or indulged they’ll keep going until someone gets seriously hurt.

                    2. Again, like a blind squirrel with a nut, they found a real fascist. OK, but one would have to be blinded by schadenfreude not to realize that these attacks are not mainly aimed at real fascists. They’re showing that they’d be willing to attack a normal person with the same boldness and self-righteousness.

                    3. But if their activities are winked at or indulged they’ll keep going until someone gets seriously hurt.

                      So I’m not allowed to feel schadenfreude as it will contribute to an eventual Oktober 1917 redux?

                      Seems legit.

                    4. there’s a contingent of lefties who really want to sit in judgment of you and I and decide if we’re worthy of being punched, our roadways obstructed, etc.

                      There’s a contingent of human beings that all secretly fantasize about murdering their opponents Eddie. Tom Kratman just wrote an entire column a couple weeks ago about Marines blowing the brains out of left-wing celebrities under martial law.

                      The left’s not in power, the left’s punching nobody skinheads on the street that you only know exist because you’re bombarded by a 24 hour news cycle. Lighten up.

                    5. “Tom Kratman just wrote an entire column”

                      responding to Rosie O’Donnel’s demand that Obama proclaim martial law to stop Trump.

                      And he said that could cause a civil war which Rosie’s side would lose, and that she and her buddies would get shot.

                      A reasonable point, I think, although of course the point was expressed with the typical delicacy one expects of a military guy and military-themed writer.

                      Again, he was saying why a *left-winger’s* suggestion of a military coup was a bad idea.

                    6. I hadn’t heard of this Tom Kratman before, but it sounds like he’s the sane one here and the lefty whom he’s criticizing is the would-be fascist.

                    7. Eh, you don’t read Kratman regularly. That’s Kratman describing it to Rosie while fetishing the hell out of it. This is a guy who openly said if he had Mattis’ job he’d start executing bureaucrats.

                    8. I hadn’t heard of this Tom Kratman before, but it sounds like he’s the sane one here

                      There are many things I would call Kratman. Intelligent. Cunning. Disciplined.

                      Entirely sane is not one of them.

                      And don’t get me wrong, that’s what I like about him. But he’s fucking nuts.

                    9. “And don’t get me wrong, that’s what I like about him. But he’s fucking nuts.”

                      OK, I’ll defer to you on this.

                    10. Maybe he simply *looked* sane next to Rosie O’Donnell.

                    11. Hmmm…OK, you’ve probably read him more than me.

                      I assumed he was simply saying “do you realize what kind of evil shit you’re wishing for?”

                    12. Tom “Space Muslims” Kratman?

                    13. “Tom “Space Muslims” Kratman?”

                      Are the Space Muslims the mortal enemies of the Pigs in Space?

                    14. And then it’s all won by some random mayor from New Mexico, after Gary from Des Moines runs the country for awhile, due to Joe Lieberman’s second son being assassinated.

          2. The progs are waiting for the Muslims to go first.

            1. Many Muslims have condemned terrorism in the name of Islam. Not sure what exact number of condemnations you are looking for. And it goes without saying, whether we are talking pro-lifers, progs, or muslims, that anyone that is a member of a group is under no obligation to speak out against violence committed by someone else that is also a member of the group. Otherwise, we would all be spending our time condemning some act of violence or other.

              1. that anyone that is a member of a group is under no obligation to speak out against violence committed by someone else that is also a member of the group.

                If you are talking about a non-voluntary grouping, like race or sex, then sure. #NotAllMen is true. However when you are talking about a voluntary association, like religion, creed, political ideology, etc., then that’s baloney. You are absolutely judged by the company you keep and if you care at all as to how your group is viewed then you would work to eliminate those that discrete the reputation of your community with extreme prejudice.

                1. Caring how your group is viewed is not the same as having a moral obligation to speak out.

                  Also, I would argue that religion is not a voluntary choice for most people. Being brainwashed into something before you even have the capacity to introspect enough about it does facilitate voluntary association. Research supports this, as does the fact that most people don’t switch from the religion into which they were born.

                  1. Caring how your group is viewed is not the same as having a moral obligation to speak out.

                    Of course it is. If someone is committing evil in your group’s name, then you have a moral obligation to condemn it. As Socrates argued 2,500 years ago, choosing not to implies tacit approval of the evil-doer’s action.

                    Also, I would argue that religion is not a voluntary choice for most people. Being brainwashed into something before you even have the capacity to introspect…

                    Nope. Not buying the religious adults don’t have any moral agency argument. I will grant some understand to the situation of say, someone living in Saudi Arabia who risks beheading for speaking too critically about the Salafist interpretation of Islam, but that still doesn’t change the fact that religion is a voluntary association.

                    1. Dafuq, HM. When did I say that religious adults don’t have any moral agency. I never said anything close to that. All I said is that most people don’t voluntarily choose their religion.

                      And I totally disagree with Socrates. I thought libertarians were opposed to positive obligation, but here you are arguing for morally compelled speech. Nope, not buying that. You have the right to remain silent.

                    2. When did I say that religious adults don’t have any moral agency. I never said anything close to that. All I said is that most people don’t voluntarily choose their religion.

                      If that’s all you meant to imply, then you shouldn’t have claimed that being born into a particular religious tradition is “brainwashing”. That’s your term. Furthermore, you used the fact that most people don’t change religions as adults as evidence for this. If that’s not implying that a religious adult doesn’t have moral agency due to childhood indoctrination, then I don’t know what is.

                      I thought libertarians were opposed to positive obligation, but here you are arguing for morally compelled speech.

                      That’s completely mendacious. I never said one was compelled to speak, but if one makes the choice not to speak against evil then one is making the choice to tacitly approve of the action.

                      So of course one has the right to remain silent. However, one does not have the right to evade criticism if they either maintain association with the group or choose to continue tacit approval through silence. As most human beings are not telepaths, if a particular action is attributed to a group and you choose to maintain association with that group, unless you state otherwise, others will deal with you on the assumption that you agree with the tenets and actions of the group.

                    3. You live somewhere in NH, correct? And that’s a choice, right? No one forced you to move there. So anytime there is a crime committed by a New Hapshirer, I expect you to publicly denounce it. Otherwise, you clearly support it. Of course that is ridiculous, but that is where your logic is leading you.

              2. From Pew:

                “Recent surveys show that most people in several countries with significant Muslim populations have an unfavorable view of ISIS, including virtually all respondents in Lebanon and 94% in Jordan. Relatively small shares say they see ISIS favorably. In some countries, considerable portions of the population do not offer an opinion about ISIS, including a majority (62%) of Pakistanis.

                Favorable views of ISIS are somewhat higher in Nigeria (14%) than most other nations. Among Nigerian Muslims, 20% say they see ISIS favorably (compared with 7% of Nigerian Christians). The Nigerian militant group Boko Haram, which has been conducting a terrorist campaign in the country for years, has sworn allegiance to ISIS.

                More generally, Muslims mostly say that suicide bombings and other forms of violence against civilians in the name of Islam are rarely or never justified, including 92% in Indonesia and 91% in Iraq. In the United States, a 2011 survey found that 86% of Muslims say that such tactics are rarely or never justified. An additional 7% say suicide bombings are sometimes justified and 1% say they are often justified in these circumstances.

                In a few countries, a quarter or more of Muslims say that these acts of violence are at least sometimes justified, including 40% in the Palestinian territories, 39% in Afghanistan, 29% in Egypt and 26% in Bangladesh.”

                Depends on the country but…that’s not an insignificant amount of people.

                1. Now compare that with non-Muslims:

                  http://fair.org/uncategorized/…..g-pundits/

        2. There’s probably been fewer attacks by pro-lifers since Roe v Wade than dead women in Kermit Gosnell’s operating room alone over that time span.

          1. Kermit Gosnell victims = 24
            pro-life murders since Roe V. Wade = 16

            Technically, you are correct. Congratulations.

            1. Now add up the level of condemnation from the national media for pro-life terrorists and Kermit Gosnell. THEN you may start getting the point, Chipper!

              I am not pro-life. I don’t need to be to note the blatant hypocrisy that is being pointed to here.

            2. Technically? That’s the best kind!

              Woohoo!

              1. Is there any other kind ?

              2. Is there any other kind ?

                1. Hypocrisy?

                  Like creating a police state to deny the fundamental rights of every woman in America, and to shit on Jefferson’s unalienable rights … while claiming to be a Constitutional conservative?

                  Or defying the Will of God ….. in the Name of God?

                  Like that?

    2. Those bloddy fetus hats must be tough to knit.

      1. Meh, it’s not hard if you just ignore their tiny screams

    3. Trump really knows how to troll lefties. Love him or hate him, respect this quality anyway.

  29. Welcome to AddictionMyth’s Libertarian Utopia. I shall call it, “New Somalia.” Make yourselves comfortable – but don’t forget to pay your insurance premiums!

  30. Commented earlier on this. But I didn’t see anything in there that ends the fedgovs drug cartel and allows patients to choose what drugs, treatments, or devices they would like to use, bought at competitive market prices, including importing.

    1. Recently (like weeks ago) there was a bill I believe that would have ended import restrictions on pharmaceuticals and I think their was considerable bipartisan *opposition* to it (like 35 or so Repubs and more than a dozen Dems, including Cory Booker and a couple other notables). Rand Paul and Ted Cruz, and even John McCain, were among 12 Republicans that supported the measure. But it failed.

      I imagine Paul is well aware that if he were to put the measure in his new bill, the same people who just voted against it would tear it out.

      It’s pretty pathetic. It was the one case where Democrats in the media actually supported free trade legislation. To their credit, a few outlets like Slate even ran articles chastising their golden boy Cory Booker for his opposition, and noting, ironically, that Trump seemed to support the measure.

    2. A challenge is the high rate of counterfeit imports.

      For example if India ships drugs to Canada for sale to the us, Canada does not regulate them.

  31. Has anyone seen the film Dallas Buyer’s Club? If not, see it.

    1. I heard only good things, and I love Mr. Alright-alright-alright. It is on my short list.

      1. It should definitely be on your short list.

    2. I’m not even a McConaughey fan, and I’d still recommend it. Good film.

  32. Better than Obamacare, but still crap. Get employers and govt out of it completely. Make it like buying auto insurance. If you are too stupid to figure out without Uncle Sam holding your hand then natural selection will run its course.

    1. Getting government out of anything makes it better. But with healthcare, it could definitely save your life.

    2. That is politically impossible.

      I also fail to see how government is not involved in auto insurance. There’s massive regulation involved regardless of whether they fund it. There’s cronyism and a basic infringement of liberty in forcing us to buy it to drive.

      There’s things I can definitely quibble with under Paul’s plan on principles, but anyone who calls a massive leap towards a freer system needs to reevaluate reality.

  33. The only way to improve healthcare is through technology and choice. That means getting government totally the fuck out of it. My healthcare and what I want to choose to do with it is not the government’s fucking business and I shouldn’t have to buy their limited choice of shitty options at cartel prices. Rand, if you would have just said that, I’d like it better.

    1. So he should have gone on an anti-government rant … instead of an actual solution?
      Lately, he seems to be learning how to avoid being a total loser. Wait ’til the goobers figure that out!

      1. Hi Mary!

          1. Oh Mary, you so crazy.

  34. Hopefully trump has enough wit to declare that “if you like your Obamacare, you can keep it.”

  35. OT: Police make swift arrests after protesters block traffic in downtown Portland

    missing from the headline “As commuters cheer on the cops”.

    Nothing will make me hate your movement more than getting in between me and my home after work.

    1. This.

      Especially for a tantrum.

    2. It would almost be worth it to see these “nonviolent protesters” get arrested like they deserve.

      1. Watch the videos from Portland- there’s one where a bunch of Che wannabe’s aren’t paying attention and the riot police tackle them before they can run.

        The crowd is literally cheering on the police.

        IN PORTLAND.

        #thisishowyougettrumpreelected

        1. #makecrackingheadsgreatagain

        2. Pretty much. The post-election protests here were violent enough to turn off most of the locals; it didn’t help that a lot of people living in apartments in the city center literally couldn’t get home for days.

          Last Friday, my wife and I dodged Inauguration protests to go to a concert off Burnside. Most of the responses to posts on the Portland PD’s Twitter feed regarding the violence were, basically, “fuck those people, and don’t be gentle”.

    3. Here’s a nice juristic question: if a bunch of idiot protesters form a human chain on the sidewalk around an entire block, thereby preventing anyone who lives there from leaving, are the residents allowed to use physical force to get past them? Remember, they’re not on anyone’s private property, they’re on public property, so they’re trespassing (or if they are, presumably only the state has the legal right to remove them?).

      1. My guess would be that there’s laws against blocking sidewalks and roadways.

        And ideally, the cops would get to those idiots before the angry neighbors do.

    4. Portland has a new mayor. Apparently, he was elected in part due to his promises not to put up with this kind of bullshit anymore. In 2015, the previous mayor turned a blind eye while protesters blocked traffic on bridges during their protest/hostage taking against the oil company icebreakers that were visiting Portland. That pissed off a lot of people. And then there were the riots after the election.

      ‘Course, he’s a standard progtard in just about every other way, but you can’t have everything…

      1. Is a progtard any worse than a libtard?

  36. OT
    San Francisco city government decides we do not have enough bums living here, acts to increase bum supply:

    “San Francisco To Launch Pilot Basic Income Program”
    […]
    “Like other basic income programs, the pilot would be designed to provide a steady income to participants, with no requirements as to how the money is spent.”
    http://hoodline.com/2017/01/sa…..-251366405

    BTW, according to the studies, the money in these programs ends up being spent for the welfare of the children and puppies in the families, and it your believe that, I’ve got some really hot deals you should act on NOW!

    1. …the OFE is considering a study that will examine how children develop in families that receive a basic income, compared to those that receive similarly valued social services and those that receive no government aid at all.

      They’ve missed a group. Families that receive no government interference at all.

    2. Guess Gillespie is moving out there to be your neighbor. I am amused that many of the people who scream the loudest about the necessity of free trade and how no one has a right to impose taxes/tariffs on goods and force others to pay more for said goods are the same people who support a UBI because, um… Where’s a Mark Perry Venn diagram when you need one?

    3. I’m sure all the brats with trust funds who live in SF enjoy the universal basic incomes they get from mommy and daddy.

  37. “The Florida chapter of the American Civil Liberties Union (ACLU) had recently secured an order requiring the Sara-
    sota police to turn over documents pertaining to
    stingray use. To prevent that information from
    being turned over to the ACLU and the public,
    the U.S. Marshals Service launched a pre-dawn
    raid on the police department to take posses-
    sion of the information. The federal government
    has also urged local law enforcement agencies to
    deceive state judges, and continues to exert pres-
    sure in favor of secrecy rather than public disclo-
    sure and oversight.”
    link

    1. Gee, thanks, I really needed a nut punch after reading this article.

  38. Where’s the health care plan where I get free, or deeply discounted, hookers and blow?

  39. Instant reactions to this proposal, without reading all the details:
    1. It’s a huge improvement on ACA, and on the pre-ACA system.
    2. It could be better. I’d love to see just one ACA replacement bill that deregulated insurance. IOW, scrap guaranteed issue, scrap the benefit mandates, and allow innovations to address payment for pre-existing illness. A form of this already exists in Switzerland, which would assuage the Euro inferiority complex of liberals who might otherwise oppose it.

    1. I was under the impression that Switzerland had some form of guaranteed issue coupled with a mandate and subsidies.

      1. They definitely have a mandate. But people have a lot of choices as to the type and level of coverage they buy.

        1. There is still a minimum standard.

          1. I’m not familiar with it, but I’d hope it’s at a level that means YOU cover your catastrophic care without becoming a load on the rest of us.
            To be clear, I hope it means that if your life is at issue, you may well have to declare bankruptcy to cover the cost, since the alternative is chancing others doing so to pay for YOUR medical care.
            Further, I hope it puts similar financial loads on your immediate family, as opposed to the public in general.

  40. It’s a step in the right direction.

    Thank you, Senator Paul.

    1. I agree.

      I just wish he would call iit something else. Obama’s name should be nowhere in whatever ends up in place. I don’t want that prick getting credit for the work others have to do to fix his fuck ups.

      1. I don’t think you have to worry about Obama getting any credit with the bill being called “The Obamacare Replacement Act.” I’d say the name immortalizes his failure on the issue.

  41. So the left take a giant dump on the thanksgiving table and we’re supposed to pick through and find the peanuts? Then they’ll take credit for the peanuts. “Without us you would’ve starved!”.

  42. I propose an Amendment which gives AmSoc’s children AIDS.

    1. I did hear that the brilliant Dr. Eye was their pediatric oncologist.

    2. Mmm, well I got a woman mean as she can be
      Well I got a woman mean as she can be
      Some-a-times I think she’s almost mean as me

      She gotta ruby lips, she got shapely hips, yeah
      Boy she makes ole Hyperion flip
      I got a woman mean as she can be

      Mmm, well I got a woman mean as she can be
      Well I got a woman mean as she can be
      Some-a-times I think she’s almost mean as me

      Mmm, well I got a woman mean as she can be
      Well I got a woman mean as she can be
      But I’m sure H&R commenters are even meaner than me

    3. I propose a second amendment which prioritizes finding the cure for Hihnfection

      I don’t care how many endangered species we need to cross-breed, and then torture. Science isn’t always pretty.

      1. I propose a second amendment which prioritizes finding the cure for Hihnfection

        There is no cure. There is no hope. We are The Walking HIhn.

        1. Great minds discuss ideas.

          Average minds discuss events.

          Small Minds discuss people.

          1. Oh Mary, you so crazy.

    4. I propose an Amendment which gives AmSoc’s children AIDS.

      Typical Paultard statist.
      How about Jews and niggers?

      1. Is a Paultard anything like a Hihntard. Bully! How’s that LIST? going, fuckstick? *gigglefarts

        1. But he’s not a foulmoth thug!

          Since HE asked …

          Fascists: John, CrustyJuggler, Tonio, John Titor, jubistar, Citizen x, Francisco D’Anconia, ace-m82, Swiss Servator, MarkLastName, bacon-magic and the many thugs and stalkers

          Hhere AGAIN is why Ron Paul is as big a con man as Charles Ponzi. Listen to his pathetic bullshit here.

          http://www.youtube.com/watch?v=vH0kHoWdK3M#t=138

          Listen as he opposes marriage equality because it would expand government benefits!! He trashes the 14th Amendment, and the entire concept of equal rights.

          http://www.youtube.com/watch?v=vH0kHoWdK3M#t=138

          Do his puppets REALLY think he opposes expanding the welfare state! Or do they need an excuse for bigotry?

          “I supported the Defense of Marriage Act, … I have also cosponsored the Marriage Protection Act, which would remove challenges to the Defense of Marriage Act from the jurisdiction of the federal courts”

          FUCKING SHAMEFUL.. THE FIRST DENIAL OF CONSTITUTIONAL PROTECTION SINCE SLAVERY,

          He also says “rogue judges” overturned DOMA, using the same argument as Orval Faubus, who used his state militia to impose segregation on 9 black kids. He lies about the 10th Amendment, REJECTS the 9th amendment, three co-equal branches, balance of power, thus leaving us DEFENSELESS from government.

          STATES HAVE POWERS WHICH HAVE NEVER BEEN DELEGATED (omg)

          Now the PC thugs will gang up on me, like a pack of wild dogs, NEVER challenging a single fact.

          (Tone and boldface in self defense of aggression)

          1. Hi Mary!

  43. “some were interpreting this as eliminating the employee tax deduction; it is not, merely extending it to individuals paying for their own as individuals or in a market-formed group”
    In point of fact, extending the exemption to everyone is essentially the same thing as getting rid of it. And that’s a good thing, because the exemption should be gotten rid of. The employee tax deduction is largely an entitlement for people who are wealthier than average.

    Unfortunately, the employee exemption is very popular, and the cleverer people who write on health care have already recommended expanding the exemption to everyone rather than getting rid of it because the former is a much easier sell to the public. Despite being the same thing for practical purposes.

    1. In point of fact, extending the exemption to everyone is essentially the same thing as getting rid of it

      It’s the exact opposite.

      And that’s a good thing, because the exemption should be gotten rid of.

      Your way is a MASSIVE tax increase. Rand’s way eliminates the discrimination with no tax increases. I proposed the same thing in 1994, explained here.

      http://libertyissues.com/healthg.htm

      I campaigned on the same thing for Washington State Insurance Commissioner, presented it to a few thousand voters at campaign events and had to make only tiny changes based on voter feedback and discussions. It was quite popular. I may have been elected if I wasn’t on the LP ticket. Republicans ran a total jerk.

      1. Sounds like Libertarians ran a total jerk, too.

        1. Why is Rand Paul a total jerk?

  44. This is frankly too good to be true. So obviously it won’t come to pass. But damn it’s an amazing improvement.

  45. That’s a good start, close to what I proposed in 1994.
    http://libertyissues.com/healthg.htm

    It’s not mentioned here but employer-paid healthcare is also exempt from FICA taxes. Perhaps in the details, The description of Association groups is off a bit. The biggest obstacle is that not all states allow them, but that may have changed since I created one for small businesses and the self-employed in Cleveland. And as for “commonality” of small businesses, the National Federation of Independent Businesses has sponsored group coverage or all types of small businesses since the late 1980s.

    1. Michael Hihn|1.25.17 @ 11:19PM|#
      “That’s a good start, close to what I proposed in 1994.”

      I’m still waiting for news from 2016: Have you heard back from whichever Koch regarding the screen shots you took of us laughing at your idiocy? I mean that was serious business, right? You were gonna get one of the Koch family to stop funding something or other ’cause we here made fun of you!
      What happened with that, Mike? (laughing!)

      1. Meanwhile, the link confirms that I had proposed it in 1994.
        With no mindless ranting!

      2. I’m still waiting for news from 2016:

        (snort) In 2017, I pointed out that employer-paid health care is also exempt from FICA taxes. But libtards close their eyes to even facts a few inches from their own nose.

  46. Drunk Driving Undocumented immigrant rights activist loses her battle to avoid being deported

    “An immigration rights activist whose own undocumented status was exposed by a drunken-driving arrest has lost her six-month legal battle to remain in the country.

    Wendy Uruchi Contreras, a Virginia organizer for the immigrant rights group CASA, was deported to Spain Tuesday after last-ditch appeals were denied by U.S. Immigration and Customs Enforcement officials.

    “We are devastated,” said her husband, Giovani Jimenez, who lives in Fredericksburg, Va., with their American-born children, Alex, 13, and Lucia, 7. “My children are crying, but we know there’s nothing more we can do.”

    [She fought to keep immigrants from being deported. Now she faces the same fate]

    Jimenez said he learned of the decision last week, days before the inauguration of President Trump.”

    Definition of entitled. Arrives here illegally becomes an activist who probably spends all day talking about how evil white people are while sucking off the teat with her anchor babies. Gets a drunk driving charge and is still pissing and moaning.

    1. while sucking off the teat with her anchor babies.

      Proof?

    2. Spain is not exactly a poor country.

  47. you think rand ever catches himself in the mirror and repeats that “most interesting man in the senate” line to himself?

    1. Dunno, but that stock shot Reason uses looks for all the world that he’s sniffing his armpit to see if the deodorant is working.

    2. Not after he fucked up his Presidential race so horribly.

      In all of humanity has anyone been stupid enough to get a standing ovation on nonintervention from Berkeley liberals, then … less than a week later … call for religious revivals nationwide … to protest the threat to our nation of … equal rights … thereby exposing the abject stupidity of his own father’s phony “liberty coalition?”

      And showing the equivalent tribal mentalitiesof progtards and libtards?
      THAT Rand Paul?

  48. “Next big march on Washington could be scientists”
    […]
    “Then someone wrote, “There needs to be a Scientists’ March on Washington.”
    “100%,” someone replied. Dozens of others agreed.”
    http://www.sfgate.com/science/…..884576.php

    Those grants are their bread and butter! You want them to find a job? Ha!

    1. people believe no science will be done if the government doesn’t support it.

      ignorant of the fact that most breakthroughs have been done by for profit companies.

      Modern Statistics was invented 100 years ago… by someone working QC for a Beer Company.

      1. I like how scientists have been elevated to unassailable holy men status. If they’re an anointed Scientist then their word is gospel.
        I fucking love science.

        1. I fucking love scienceAnd hate free speech.
          SEIG HEIL!

        2. And computer scientists are like wizards. And when they do scary stuff it is “hacking”, even when that doesn’t actually have anything to do with the true definition of “hack”. And they use their black magic to run the WORLD and control society at every level!! They even elected the PRESIDENT with their black magic!! Oops, I mean science. Not black magic.

      2. Wow. Very scientific observation.

  49. In case you needed any more reassurance that this guy needs to be dropped off in the nastiest fevuela in Venezuela possible with no phone and no papers I give you exhibit 5489.

    Tucker Carlson vs Jonathan Gruber: Obamacare

    1. fevuela I meant barrio. Sorry drunk.

      1. I think you’re taking things a bit far. i think Detroit would be fine.

        1. Detroit won’t take him.

    2. I cant even watch that guy. That execrable son of a bitch is the personification of the ‘intellectual’ that consistently arrives at the wrong conclusion but makes up for it by being supremely confident that he is smarter than everyone else.

      1. Are you talking about the reporter or Gruber? The reporter is a scumbag for sure but I’m pretty sure that Gruber guy is a terrorist trying to get back at America for letting his brother die. Working us from the inside. I think he’s even the same guy who was bragging out lying to the public in order to get the ACA passed. Openly, unabashedly mocking the American public.

    3. Yeah, Tucker is a total asshole here — claiming that most Americans want total repeal of Obamacare. A lie first addressed by … Rand Paul.

      Then Tucker got crushed for all his lies. Obamacare is bad enough on its own, without the bullshit and hysterical manipulation.

      1. Wake up!!!!!

        It’s not going to be a “total repeal”. It is going to be fixed!

  50. It’s very cool that he didn’t wait for the Trump team to come up with a replacement.

    It seems to be inevitable that the government is going to be involved in health insurance is a massive way, so anything that is more market oriented is going to be a big plus.

    1. Market oriented as opposed to government provided?

      At least use some better buzzphrases

      Tort reform
      Patient centric
      Free choice

  51. This Libertarian Moment brought to you by Donald J. Trump

  52. Commetariat, I don’t get it. My prog friends are all giddy at the white supremacist getting sucker punched, and watching videos and memes of it everywhere.

    So apparently violence is okay against someone who is only just *speaking* during a media interview. Totally ignorant of what Fascism is.

    1. And for every instance of a prog using violence against an actual fascist, there are 20 instances of progs using violence against non-fascists, unless you think windows, limousines owned by immigrants, controversial campus speakers, etc., are all fascists.

    2. What do you mean you don’t get it? What is to get? The left has always behaved this way. Leftism appeals to envy, greed, resentment and control through fear and violence. Appeal to the worst parts of human nature and you attract the worst kinds of humans. They hold irrational positions because they are driven by emotion. Of course people like that are going to be disposed towards violence.

    3. Asshole says Hitler was okay when he was only speaking.
      But he says “prog” so all the bobbleheads nod.

      On a topic that has nothing to do with this page.
      Because goobers are, well, goobers,

      1. *punches Hihn*

        What?? It’s okay apparently. Words are violence now!!

        1. Behold the dumbass thug!!!

          Asshole says Hitler was okay when he was only speaking.

          *punches Hihn*
          What??

          (snicker)

          It’s okay apparently. Words are violence now!!

          What I said, chump, is that words are irrelevant compared with actions,.
          So we now have two who believe Hitler was okay when he was only speaking.
          Any others?

          Posted in self-defense of aggression

  53. Rand Paul, my man! If only he were the man with the bully pulpit.

    1. When he had the bully pulpit, he ran the absolute dumbest Presidential campaign in US history!

      He gets a standing ovation at Berkeley, talking non-intervention. Then — less than a week later — he fucks it all away by calling for religious tent revivals nationwide, to defend homophobic bigotry and shit on the Constitution.
      Only the Paulista Cult’s so-called Liberty (sic) Movement could think those two groups both fit into the same coalition.

  54. Obamacare focused on the wrong problem. It focused on increasing demand (IE more people with insurance) instead of increasing supply.

    If you increase supply and allow for competition, then costs come down and healthcare for everyone becomes more affordable.

    If you increase demand without increasing supply then costs go up (which is what they’ve done).

    A good start would be
    1. Remove to cap on new doctors
    2. Dramatically expand the roles of non doctors
    3. Make it illegal to charge different people different prices for the same operation (IE different prices for insurers, and private and government) and then post all prices on line.
    4. Dramatically simpify billing and increase use of technology to reduce overhead costs.

    1. Obamacare focused on the wrong problem

      As totally stupid as Cato’s Medicare Vouchers which increase competition …. in the wrong market!! Insurance is not health care, and the Medicare provider market has always had competition but seniors have no skin in the game, So the “champion of free markets” targets the wrong market, and ignores over 50 years of demanding skin in the game.

      Even crazier — adding insurance companies looks like “privatization” to goobers, but Cato would insert a costly and useless middleman between the government and providers.

  55. Unless you seriously overhaul HSAs, I want no part of them. The one I had a 5 or 6 years ago was complete trash.

    1. They’re not very popular anywhere, Another soundbite by Cato and others, to sucker donors with. But not quite as crazy as claiming Medicare Vouchers are privatization.

    2. HSA are great. Especially if youre in a high tax bracket

      1. HSA are great. Especially if youre in a high tax bracket

        Progressive bullshit. Corrected here:

        https://reason.com/blog/2017/01…..nt_6711999

  56. Rand Paul 2024!

    1. Would he fuck it up so totally as he did for 2016? Within the same week, getting a standing ovation from Berkeley liberals on nonintervention — then calling for religious tent revivals nationwide to protest … equal rights!!!
      How retarded is it to think Berkeley liberals and extreme socons could be in the same coalition?

  57. Can somebody help me out here on the Tax Credit for HSA contribution? For a self employed person (for example:me)had a 10K federal tax bill, would he/she be able to put that money into and HSA and zero out the federal tax obligation? Also: would health insurance become fully deductible?

    1. Yes it would reduce your taxes by 5,000. If you had zero tax liability the government would give you $5000

      1. $5,0000 does not “zero out” a $10,000 tax bill.
        $5,000 is a pretty damn stupid amount, but that’s a separate issue.

  58. The question that always arises and is never answered by conservatives or “libertarians”: what exactly are the objectives of whatever is being proposed?
    1) will this move the country to what is a given in every other advanced western democracy: universal, quality care that is affordable for everyone (i.e., ultimately costed to consumer based on means)?
    2) what is the approximate timeline for achieving what percentage of universal coverage?
    3) what mechanisms are there for adapting implementation or regulatory change if objectives remain unmet
    4) what is your position on the notion that, as a market, healthcare is one with effectively infinite demand given that those who are chronically or terminally ill can never exhaust their demand
    5) are you familiar with the work of Uwe Reinhardt?

    Note: the word “access” is invalid, as in “access to healthcare”. I have access to fly first class all the time. However, I don’t have the means and therefore my access is as good as non-existent.

    1. “1) will this move the country to what is a given in every other advanced western democracy: universal, quality care that is affordable for everyone (i.e., ultimately costed to consumer based on means)?”

      Yes.

      “2) what is the approximate timeline for achieving what percentage of universal coverage?”

      6 years seems fair, all things considered. It’s the timeline that was given to the last guy who tried to change the system and failed.

      “3) what mechanisms are there for adapting implementation or regulatory change if objectives remain unmet”

      Partially because of your question 5, my answer here is “are you familiar with the work of F. A. Hayek??”

      “4) what is your position on the notion that, as a market, healthcare is one with effectively infinite demand given that those who are chronically or terminally ill can never exhaust their demand”

      “Infinite demand”. Just because “demand” is always present doesn’t mean it is “infinite”. The chronically or terminally ill person still has ~just~ the demands of what they need to keep them alive. Basic math states this is theoretically quantifiable and below infinite. If there was infinite demand (in a theoretical universe where “infinite demand” is possible) then you should be able to go into the business of making bandaids, charge $10,000 per bandaid, and sell everything you make.

      1. “5) are you familiar with the work of Uwe Reinhardt?”

        Do you really think trusting a guy who works /in/ the healthcare industry to write open and honest pieces on healthcare economics and give solutions that will not benefit healthcare insiders like himself??

        1. “5) are you familiar with the work of Uwe Reinhardt?”

          Do you really think trusting a guy who works /in/ the healthcare industry to write open and honest pieces on healthcare economics and give solutions that will not benefit healthcare insiders like himself?

          Mindless bullshit and bluffs like yours are why we lose.

          Reinhardt is a professor of political economy at Princeton and on the editorial boards of several prominent medical publications,

          https://en.wikipedia.org/wiki/Uwe_Reinhardt

          Do free markets a favor … sit down and shut up.

      2. “1) will this move the country to what is a given in every other advanced western democracy: ?. ?”

        Yes.

        The correct answer is no … and that his question is bullshit.

        Political health care means betting your life, literally, that politicians, faced with tight money, will INCREASE YOUR TAXES instead of cutting your benefits. If that alone doesn’t expose the fallacy, look to reality.

        Canada’s medicare was ruled an unconstitutional threat to human life, citing Canadians dying on waiting list of a year or more, caused by cuts in the federal share during the late 90s. It took a court order to force re-funding, And the Court ruling to allow non-government sources for timely service.

        In England, THOUSANDS of patients died — abandoned in hospital rooms — many found in their own excrement — from staff cuts dues to inadequate government funding.

        PROOF is this summary report by Canada’s CBC. Google the court case for details on that..

        http://www.cbc.ca/news2/background/healthcare/

        This is the British atrocity

        The British study also found the death rate in British hospitals was 45% HIGHER than ours.

        Fiscal conservatives do a SHITTY job of countering the bullshit. Conservatives and libertarians focus on anti-gummint screeching instead of actual facts (and solutions)

  59. HSAs are the biggest fraud in healthcare. We already know that Republicans only want rich folks to have healthcare but why telegraph the fact to the world?

    1. You have been brainwashed on HSAs

      Health insurance is like buying car insurance that pays for car washes. That would be stupid, right? But if your car insurance was provided by your employer, and tax free, then unions would negotiate car washes into car insurance, because cash wages are taxable.

      But you’re paying insurance companies to process claims for … car washes … which means car washes cost more (including the claims processing) right? Hypothetically, a $10 car wash would add $11.50 to the insurance premium.

      So … if the car washes were removed from insurance and the premium was added to your wages, you’d get a wage increase of $11.50, pay the $10 car wash with cash or a debit card, and pocket the $1.50 that had paid for useless claims processing. Got it?

      An HSA means the $11.50 would go into your own account — rich or poor. (That’s where you got suckered)

      Why not just give you the cash? Because the gummint won’t allow it — unless you pay income taxes on the $11.50 — even though TOTAL compensation hasn’t changed a penny.

      So it’s the GUMMINT that forces you to pay for the car wash out of a special account, an account fed with tax-free income.

      HSA’s are a gimmick to get around the gummint distortion of wages. Clear now?
      There are several ways to do that, but libertarians and conservatives are as easily brainwashed on government as you are on the rich.

      1. Agreed. I’m guessing if Longtail were rich the tune would be a bit different. Always easier to spend other people’s money.

        1. You may be charitable on that. 🙂
          There’s plenty of rich folks on the loony left. What would Soros say? (I seriously don’t know. Google gave me nothing. )

  60. Sounds good. Of course, Paul is a doctor and thus has actual experience in the system.

    1. You buy gasoline. Does that make you an expert on the oil industry?

  61. The Man Who Should Be President. Viva RAND! (a Libertarian for Trump as with Walter Block)

    1. Rand is too fucking stupid everywhere else to be President.

      Like when he got a standing ovation at Berkeley, speaking on nonintervention, then pissed it ll away — less than a week later — calling for nationwide religious tent revivals, to defend homophobic bigotry.

      Since the insanity of Donald Trump grows from the bigotry and anti-constitutional statism of Ron Paul.

      1. Like when he got a standing ovation at Berkeley, speaking on nonintervention, then pissed it ll away — less than a week later — calling for nationwide religious tent revivals, to defend homophobic bigotry.

        Which libertarian principles do “nationwide religious tent revivals” or even “homophobic bigotry” violate?

        1. Another cult member. Tent revivals are fine.

          Homophobic bigotry is fine … unless one tries to impose that bigotry by law, which also violates the Constitution. For the same reason I already explained to you regarding his wacky father. States have NO power to discriminate in that manner. NONE.

          Listen as he opposes marriage equality because it would expand government benefits!! He trashes the 14th Amendment, and the entire concept of equal rights.

          http://www.youtube.com/watch?v=vH0kHoWdK3M#t=138

          Do his puppets REALLY think he opposes expanding the welfare state! Or do they need an excuse for bigotry?

          “I supported the Defense of Marriage Act, … I have also cosponsored the Marriage Protection Act, which would remove challenges to the Defense of Marriage Act from the jurisdiction of the federal courts”

          FUCKING SHAMEFUL.. THE FIRST DENIAL OF CONSTITUTIONAL PROTECTION SINCE SLAVERY,

          He also says “rogue judges” overturned DOMA, using the same argument as Orval Faubus, who used his state militia to impose segregation on 9 black kids. He lies about the 10th Amendment and REJECTS the 9th amendment,

          Pandering to the crazy elements of the religious right is NOT libertarian.

  62. Free Market Medicine, babay…

  63. Deductible.

    So this will be useful to people who today only receive the standard deduction?

    1. I published a more equitable way over 20 years ago. Increase the standard deduction by an amount equal to average premiums for that family’s size — or the same amount itemized. By using averages, there would be a tax INCREASE– only on those who abuse the current system, unions and the rich. So the exploiters thus help pay for the exploited.

      http://libertyissues.com/healthg.htm

      That 1994 piece did not address the uninsured, which was not then an issue. But Medicaid should be folded in to Friedman’s Negative Income Tax — which is NOT a Guaranteed Basic Income, despite anti-gummint screeching to the contrary.

  64. Sounds like an organization like Associated Food Stores, which is around 500 independent grocery stores in Utah, Arizona, Idaho, Colorado, Montana, Oregon, Nevada, and Wyoming that work together to lower costs of products through making large purchases as if they were one large company could benefit a lot from this plan.

    They could go together to do a large volume purchase of employee health care plans, good in any State where there are Associated Food Stores – instead of having to have each store or small chain of stores deal individually with insurers, and the problems that come when an employee moves to a different State where the insurer they are with doesn’t do business.

    There’s no reason why health insurance shouldn’t be available and work nationally just like vehicle insurance.

    If you buy insurance for your car in Florida and someone sideswipes you in California, you still get paid and your car still gets repaired.

    If you buy health insurance in Florida and you break a leg in California, it can cost you a ton of money while your expensive insurance pays for nothing.

    If millions of people could all pay a small amount per month to one company operating online, like The General, that would spread the risk and reduce the costs *if* that insurance was required to be accepted identically across the country.

    I can see the commercials with a cartoon Army General in a doctor’s coat… “Come to The General and save your health!”

    1. Sounds like an organization like Associated Food Stores, which is around 500 independent grocery stores …..

      They likely already have one, since Association Coverage has been available for over 50 years.

      I do recall using them as an example, for a published op-ed in the HillaryCare days because Hillarycare would have banned such plans … and banned thousands of self-financed plans, like we had when I was a school board member. Self-financed plans by the EMPLOYER are much better than HSAs, but fiscal conservatives all recite the same anti-gummint soundbites.

      We paid EVERYTHING with cash for our employees — everything — but had a HUGE deductible insurance on the entire workforce. Cato and their cronies are kind stupid on health insurance. Anti-gummint instead of pro-market, so they don’t even ask the right questions.

      Think of an HSA at the employer level. They’ve been around for well over a quarter-century. The school board I described was the late 80s, and it was well established at the time.

  65. Personally I like Rand. I think he has some good ideas and hopefully they can come up with something that works for everyone that won’t kill everyone’s bank account.

  66. Good thing those socialist Democrats aren’t in power.

    1. Good thing those socialist Democrats aren’t in power.

      Yeah, the socialist Republicans are SO much better. They haven’t fucked with us since Dubya.

  67. Ugh! HSA’s, again. Gotta love how HSA’s completely miss the whole point of insurance.

    *Insurance* is for events which are: 1) uncommon (meaning: it doesn’t happen to many people), 2) unforeseeable, and 3) catastrophic (meaning that, if it happens to someone who’s not wealthy, it wipes them out). Think natural disasters which have a 0.01% chance of obliterating your home, or some crazy type of leukemia which costs $1M to treat.

    *Savings* is for things which: 1) happen to everybody (like retirement), 2) foreseeable (like a vacation), and 3) affordable (in that you can actually save up that much)

    The idea that you can just “get everybody to be responsible enough to save for their *own* health costs” by just letting them sock away $5k/year tax-free fails in a variety of areas:
    1) People who are even *able* to save an additional $5k/yr usually *already* have health insurance. The uninsured are living hand-to-mouth.
    2) Even if they *could* afford to put away $5k/yr, it’s going to take them 100 years to put away enough for some $500k treatment (and that’s if they never get any *other* moderately-costly illness in those 100 years)
    3) Most people aren’t going to *get* a catastrophic illness, so it doesn’t make any sense for everybody to be sequestering a big chunk of money out of the economy.

    So, in short, HSA’s are just a disguised way for rich, healthy guys (like myself) to skirt taxes on another $5k/year. Thanks, Rand!

    1. Gotta love how HSA’s completely miss the whole point of insurance.

      You have many misconceptions.,.

      *Insurance* is for events which are: 1) uncommon (…. )

      So are HSAs, but people decide that for themselves.

      *Savings* is for things which: 1) happen to everybody (like retirement), …

      The “savings” here means saving money on healthcare. Savings can be short-term.

      The idea that you can just “get everybody to be responsible enough to save for their *own* health costs” by just letting them sock away $5k/year tax-free fails in a variety of areas:

      That’s YOUR idea. Your failure.

      1) People who are even *able* to save an additional $5k/yr usually *already* have health insurance. (babble deleted)

      You confuse HSAs for the insured with a proposal for the uninsured. The uninsured get $5,000 — like a prepaid debit card.

      Even if they *could* afford to put away $5k/yr,

      They’d buy insurance for your nightmare scenario … which is the purpose of it!

      3) Most people aren’t going to *get* a catastrophic illness, ….

      The idea is crazy, but for different reason.

      Now if you weren’t channeling Bernie, and understood it, you might say that $5,000 is a bullshit number, which it is. But the principle is sound.

      1. That $5K would not pay for even one month of cancer therapy.

        1. Since it’s not supposed to, that is completely irrelevant.

    2. 3) Most people aren’t going to *get* a catastrophic illness, so it doesn’t make any sense for everybody to be sequestering a big chunk of money out of the economy.

      Yeah, god forbid people save up money for their own expenses. FREE SHIT FTW!!

      1. Typically irrelevant use of a memorized soundbite.

  68. “These can include nonprofit organizations (including churches, alumni associations, trade associations, other civic groups, or entities formed strictly for establishing an IHP)”

    Aw, sweet, now I can get health insurance from my local church.

    1. Too small. Too small to be worth it. Your Synod or whatever works for your denomination.
      When I sold office equipment, the Catholic Diocese had a purchasing office for EVERY Catholic erntity in Cleveland’s county, That’s an obvious group.

      The group must be both large and have a stable membership, or the group has zero market value.

  69. Good thing deficits no longer matter so other than the costs, Paul has produced a replacement

  70. We are finally on the right track but understand this is ONLY Rand Paul’s “Option” to the President for consideration when applying the Replacement. This is not “THE” Replacement as the article title suggests.

    1. That’s a distinction without a difference. And the $5,000 tax credit used by Republicans is shameful vote buying. It’s WAY too high but ignores families with children.

      Republicans are famous for looting the Treasury to buy middle-class votes. See the Bush tax cuts and Medicare prescriptions. The prescriptions add over a quarter-trillion to current deficits, which they have the gall to blame on Obama.

      1. Businesses have no cap on the tax credit they receive for offering health insurance. This is a plan to decouple insurance from employment which is what pretty much every free market economist advocates. This plan just gives the self-employed and contract workers the same tax treatment as someone working for a large business.

      2. Businesses have no cap on the tax credit they receive for offering health insurance. This is a plan to decouple insurance from employment which is what pretty much every free market economist advocates. This plan just gives the self-employed and contract workers the same tax treatment as someone working for a large business.

      3. Correct on the prescriptions and Obama ignored this along with most everything else while in office except about the last two months where he consumed himself with self-righteousness and connived to do everything he could to try to make President Trump’s job miserable. Atta Boy!!

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  74. black people don’t know we want them out of prison, Why doesn’t Reason tell them?

  75. If you ever get cancer and confront the high cost of medicine, you will realize that an HSA is practically useless. And if you are not upper middle class, you could not afford it, anyway.

    1. Hence why insurance exists. Paul’s plan does not get rid of health insurance.

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  77. If the Republicans are dumb enough to let one poor family lose their healthcare, said family will be media darlings crying over the fact that “I can’t take my sick baby to the doctor”. It’s time for some form of universal health care. Get the damn insurance companies out of the way. They are parasites. France is an excellent example of a two tiered system that provides free baseline (limited) care for the economically disadvantaged and allows supplemental insurance for those who can afford it, want to chose their doctors and have access to the latest technology. The French spend about a third less on healthcare than the US and have demonstrably better outcomes.

  78. If the Republicans are dumb enough to let one poor family lose their healthcare, said family will be media darlings crying over the fact that “I can’t take my sick baby to the doctor”. It’s time for some form of universal health care. Get the damn insurance companies out of the way. They are parasites. France is an excellent example of a two tiered system that provides free baseline (limited) care for the economically disadvantaged and allows supplemental insurance for those who can afford it, want to chose their doctors and have access to the latest technology. The French spend about a third less on healthcare than the US and have demonstrably better outcomes.

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