health care

The GOP Repeal Plan Sucks. But Is it Better Than Nothing?

Not necessarily.

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First of all, the preferred free-market plan for health care policy should be no plan whatsoever. The idea that we need a federal top-down strategy to manage a huge chunk of the economy is at the very heart of the problem. We don't need a federal plan for health care. Yet Republicans have allowed liberals to frame the entire health insurance debate in these anti-market terms.

So the American Health Care Act, or AHCA, is obviously weak tea, falling far short of a promised free-market solution, much less a full "repeal" of Obamacare. It's a half-measure that endeavors to fix Obamacare with small doses of deregulation while failing to repeal its core. It's almost as if Republicans were trying to mollify their constituents and save Obamacare at the same time.

President Donald Trump tweeted something about a three-phase rollout, but the specifics of the other two parts have yet to be confirmed. Perhaps the full proposal will reflect better on Republicans. But considering the noise moderate senators have been making and Trump's own views on entitlement programs, it's unlikely to meet conservative expectations. So what can be done?

In a piece highly critical of the plan, the Washington Examiner's Philip Klein, who has done some of the most insightful writing on Obamacare, states, "the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place." What if this is the choice?

We know the Democratic Party's plan for health care: Constrain markets to create monopolies that can be controlled by a federal regulatory regime (this is why liberals oppose markets expanding across state lines); and rather than worrying about access, choice or cost, continue to incentivize the growth of the welfare state. When this situation becomes untenable, pass single-payer. What Democrats understand but Republicans often don't is that you can reach your goals incrementally.

Obamacare was ignored as soon as it was passed. A law that was sold as a tool to reign in rising costs quickly became a moral edifice that alleviated an imaginary humanitarian crisis (the defense of it is now almost exclusively focused on people losing Medicaid). Meanwhile, Obamacare was used as a tool for social engineering and coercion, allowing technocrats to dictate how a third of the economy functions. If you control the bureaucracy, laws become incredibly malleable. One day, Democrats will be back and, without even partial repeal, all the same mechanisms will be available to them.

So the question remains: Is something better than nothing?

Halting federal funding of the nation's largest abortion mill is a victory. Offering states more flexibility to run their own Medicaid programs is a victory. Expanded health savings accounts and the creation of real-life illustrations of successes is promising. Getting rid of the individual mandate is a victory, as is allowing consumers to purchase insurance across state lines. Repealing nearly all of Obamacare's taxes—other than a postponement of the Cadillac tax—is a win.

It's possible, of course, that AHCA negotiations will begin with moderate proposals and transform into something free market-oriented. With widespread opposition from conservative groups—Heritage Action for America, FreedomWorks, etc.—the American Health Care Act looks like a non-starter. Then again, who are we kidding? The truth is that conservatives probably find themselves in the same situation frustrated liberals did in 2009. Despite prevailing mythology, Democrats never compromised in good faith with the opposing party; they compromised with their own moderates. It only takes a few senators to hold an entire party hostage.

It's also worth pointing out that no federal entitlement program has ever been repealed or replaced, or really even weakened. This was the fight that spurred Republicans to win hundreds of seats and take the House, Senate and presidency. The fact is that many politicians who benefitted most from Obamacare's failures were lying to their constituents. Either these Republicans don't have the mettle to back a full repeal or they don't have the ideas to create a new plan. So perhaps Obamacare Lite is preferable to Obamacare because it's the best this crop of legislators is going to do. Also, as history has shown, making substantive policy changes doesn't get any easier as a term wears on. This might be the last chance to do anything.

Another infuriating aspect of this fiasco is that Democrats will treat any Obamacare "repeal" bill as if it were an assault on all that is holy and patriotic. This rhetoric shouldn't have inhibited Republicans; it should have freed them to pass bills that incorporate the ideas they supposedly believe in. Why would they let the same people who told America that Obamacare would be a political and functional success now lecture them on how unpopular a repeal bill will be?

It's just one of the many mysteries of the GOP.

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  1. Yet Republicans have allowed liberals to frame the entire health insurance debate in these anti-market terms.

    I wrote to my senators and congressman about this exact thing. I said that I want them to repeal ObamaCare. If they don’t (1) ObamaCare survived and Obama and the Democrats will not been utterly defeated with that pipe dream (2) Republicans will be seen as very similar to Democrats in the next election and lose seats (3) Democrats will take whatever is left of ObamaCare and run with it next time they control Congress and the presidency.

    1. Obama and the Democrats will not been utterly defeated with that pipe dream

      And here is the real problem. The Republican base’s primary policy goal isn’t free markets, improving healthcare, or anything worthwhile. It’s purely a desire to humiliate their political opponents.

      Unfortunately, that is hard to sell to the general public, who don’t share the GOP’s childish obsessions.

      1. Unfortunately, that is hard to sell to the general public, who don’t share the GOP’s childish obsessions

        Are you serious? Because there’s a guy in the top chair right now who embodies that attitude, and it came about in no small part because the Democrats’ base are the exact same way.

        1. There’s degrees to this sentiment, no? I can totally understand conservative-types cheering for a guy who says things that piss off liberals (this kind of trolling mentality is pretty universal to humans, I think), but still stop short of wanting to get rid of government programs and policies they personally benefit from, even if it comes from “the other side.”

          This gets to something I think Republicans fundamentally have to grapple with: their core policies are not especially popular. Pluralities if not majorities of voters like things like accessible healthcare with broad benefits, and SS, and they don’t mind taxing the rich to get it. This runs opposite to the GOP’s positions. This inherent clash is compounded by the defacto leader of the party being a populist.

          1. That’s pretty close to the mark. So will politics stop in a democracy when they run out of identifiable classes of persons to screw, & thus hit equilibrium?

            1. The people who believe in social democracy / the Welfare state don’t believe they’re screwing anybody. Some of them might believe that other, ideal arrangements would be better than the Welfare state, but they’re pretty sure they’re not going to get them, and they don’t care for a social order in which untrammeled capitalism runs its course and the poor, and maybe they themselves, die on the streets because they didn’t luck out. The only error in mortiscrum’s picture of the situation is ‘taxing the rich’; more and more of the proles (us) seem to have come to understand that the rich simply aren’t really taxed.

              In fact in the case of Obamacare and its successor(s), which liberals correctly pointed out would be pretty much alike a long time ago, we not only observe the rich not being taxed but large amounts of wealth being moved from the proles to the rich by government command. I’ve pointed this out to my soc-dem friends and they say it’s the best they can get. Some of them are people who might be the ones dying in the streets without the Welfare state, so it’s a strong issue with them.

              There are other ways of solving the problem but none of them start with ‘Qu’ils mangent de la brioche’ as so many of you libertarians seem to think.

          2. Pluralities if not majorities of voters like things like accessible healthcare with broad benefits, and SS, and they don’t mind taxing the rich to get it.

            Well, yeah, if you think someone else is going to pay for your shit and a strongman will make it happen, of course it’s going to be popular.

      2. The Republican base’s primary policy goal isn’t free markets, improving healthcare, or anything worthwhile. It’s purely a desire to humiliate their political opponents.

        Unfortunately, that is hard to sell to the general public, who don’t share the GOP’s childish obsessions.

        But the Republican base is a large chunk of the general public. And unfortunately I think a lot of that is for real among the general public, i.e. snickering over their co-workers, relatives, etc. just as they might over spectator sports.

      3. Not even that. The primary goal of any politician of any stripe is to get re-elected. The primary goal of any political party is to grow their power base and make it easier for incumbents to get re-elected and to keep their donor base happy.

    2. I called my congressman’s office and told them if she voted for this turd that I would not only vote for someone else i the primary, but that I would give them every dime I could spare.

    3. Democrats controlled the presidency and both houses of Congress in 2008 to 2010, 1992 to 1994, and I think the first two years (or was it all four) of the Carter administration. So, about every 16 years, Democrats get back in control. I have no reason to believe this will not be the case in 2024, especially with Republicans seeming to do everything they can to throw their own majority away. I wouldn’t be at all surprised by a Democrat president in 2020.

      1. As of today, bet your house on a Democrat sweep nest year, taking back both houses of Congress. Even the governor races are extra-heavy with GOP governors on states carried by Hillary.

        Republicans suffer the same arrogance that cost Democrats the White House and both Houses of Congress.

  2. It’s worse than nothing. A lot worse than nothing. It’d be better, politically, to do nothing and just let it die. Enforce all provisions and let the chips fall.

    But that’d hurt a lot of people. So I get the “need” to do “something”.

    But why not try small things and, if they don’t work, then try something else. I’ve done tech support on cell phones and computers in my life and a total factory reset was never the FIRST step I took. I tried smaller things first before trying to more annoying things.

    1. The political problem is that when the small change doesn’t work, that small change will be blamed for the failure.

      1. And we will never, ever get the factory reset.

        1. Actually, we *can* get the factory reset. Unfortunately, in politics, the factory reset involves lots of blood in the streets, and it’s very likely to mean a major loss of freedom, too…

          1. Actually, we *can* get the factory reset. Unfortunately, in politics, the factory reset involves lots of blood in the streets

            Or fiscal conservatives with more brains than a rock.
            Okay, blood is more lilkely.

  3. Repealing and making one at a time tweaks is much better.

    1. For a Democrat landslide.

  4. The idea that we need a federal top-down strategy to manage a huge chunk of the economy is at the very heart of the problem.

    Exactamundo. Unless you’re a doctor treating patients, health care really isn’t all that complicated. What’s complicated is devising schemes to redistribute the costs of healthcare, all the while seeking to ensure that everyone thinks he’s the one getting the better end of the deal.

    1. But … how did we manage to TREAT everyone? For anything? As in the past. And how do we restore what Americans obviously want .. and what they paid for?

      1. In many cases, we didn’t treat everyone. Nor did we know how to. Until we bring costs down, treating everyone with everything we know now is simply not possible.

        1. In many cases, we didn’t treat everyone

          Non-responsive. Read it again.
          We DID treat everyone … for everything … IN THE PAST. Since Americans paid for it, that must be what they wanted!! Do you understand voluntary payments?

          Charity Hospitals cared for the uninsured, including elderly. Right up until Medicare and Medicaid. Paid for from the collection plate. We had 100% treatment, with very few exceptions, and healthcare was less than 8% of GDP.

          Before WWII, and for maybe a decade afterward, “coverage:” was provided by then-common ethnic and fraternal lodges. There were no health insurance companies until employer-based replaced ethnic-based (and similar). Blue Cross popped up after WWII, with the first serious employer-based coverage, (So did HMO co-ops, controlled by patients, but we’re not allowed to know that)

          Medicare and Medicaid, especially the latter, killed the Charity Hospitals. Why put money in the collection plate (a) when there is no need and (b) on top of the taxes?.

          So the almost obvious question is … how do we transition back to what worked so well before? Nobody gives a shit about that. So we lose … because NOBODY is showing how to better provide what government does now .. which is what most Americans want.

          1. Medicare and Medicaid, especially the latter, killed the Charity Hospitals. Why put money in the collection plate (a) when there is no need and (b) on top of the taxes?.

            A big reason why the Catholic Church supported these programs, as well–they saw them as a way to get someone else to take care of their flock.

            1. So the almost obvious question is … how do we transition back to what worked so well before? Nobody gives a shit about that

              a way to get someone else to take care of their flock.

              Thanks for proving me correct. … about you and your ilk. I’m an atheist … but never a hate-spewing bigot. By the way, ALL religious hospitals were charity hospitals, including the Lutheran Hospital I was born in. And NONE of them treated only their own flock. But, again, thanks for proving my point,

              1. So sensitive.

                1. So sensitive.

                  That was a mix of gloating and ridicule.
                  As is this.

                  1. That was a mix of gloating and ridicule.

                    More like a mix of butthurt and self-righteousness.

                    1. (lol)

                      Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people.

                      And haters gotta hate.

                    2. LOL indeed.

                      Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people

                      And microscopic minds offer insubstantial quotes to disguise their lack of debating skills and reading comprehension.

                      And haters gotta hate.

                      As Hihnsanity so effectively demonstrates with every post.

                    3. As Hihnsanity so effectively demonstrates with every post.

                      (yawn)
                      https://reason.com/archives/201…..nt_6790815

                      As he calls me Hihnsanity!! (smirk)

                    4. Hihnsanity once again posts his unsourced link.

                      (twirls away smirking)

          2. ‘So the almost obvious question is … how do we transition back to what worked so well before?’

            Maybe that’s not possible. A lot of things have changed profoundly since 1939.

            I’m interested, though, in your mention of HMO co-ops. They seem like a vastly preferable solution, yet no one even talks about them, and very few actually exist. Why are we not allowed to talk about them?

            1. ‘… how do we transition back to what worked so well before?’

              Maybe that’s not possible.

              Name one. Or see a whole flock of them here … from the early to mid 1990s (It’s a web archive. Check taxes and federalism)
              http://libertyissues.com/archive.htm

              I’m interested, though, in your mention of HMO co-ops. They seem like a vastly preferable solution, yet no one even talks about them, and very few actually exist. Why are we not allowed to talk about them?

              Because they would DESTROY both public and private third-party coverage!

              Originally proposed by Obama, as an alternative to a public plan, to get GOP votes. Seattle’s Group Health. I was a member for 17 years. Doctors are salaried employees of their patients, run their own pharmacy and hospitals, so ZERO reimbursement overhead. Pick up prescription on your way out of the clinic. It was endorsed on far-left by Daily Kos and praised by the New York Times. To the far left, non-profit and member-owned is “socialized medicine.” Yep.

              It’s the modern version of the fraternal/ethnic lodges that financed treatment pre-FDR.
              Skip the bullshit. GOP refusal on this created Obamacare as passed. Obama had campaigned far to the right of Hillary on health care, saying we had to reduce costs BEFORE considering universal coverage (duh) ? as shown in a 2012 Gary Johnson campaign ad.

              The GOP refusal forced Obama to deal with his far-left.

      2. Perhaps I’m naive, but why not just allow healthcare providers to set their own prices? Hear me out.

        We all know that the insurance companies have caused healthcare pricing to not only increase but to become convoluted to the point that no one knows what anything actually costs (see hospital chargemaster). If we remove the 3rd party payors, then healthcare providers could completely reevaluate their actual costs & provide consumers with accurate prices which they could use to shop around & find the best deal.

        It wouldn’t be perfect. It would create a free market with some doctors pricing on the low end of the spectrum & some on the high end, & consumers would shop around within their price point, just like any other product. But to dismiss the entire idea because some doctors would overcharge is like saying that since not everyone can drink Boerl & Kroff Brut, we all have to drink Robert Mondavi.

        1. That’s all well and good, but you have half the country screeching that health care is a “right”. Nothing like this plan has a hope of passing; not before the whole thing comes crashing down first.

          1. Boerl & Kroff Brut for everyone! Don’t worry, we’ll make the 1% pay for it!

        2. I’m extremely skeptical, to the point of finding the idea absurd, that health care costs would go down so much without third party payers and government interference that it’d become broadly affordable to the average American.

          Insurance companies exist for a reason. Health care gets extremely expensive extremely quickly. What you’re proposing seems to be a lowering of health care demand by locking millions of people out of the market by not allowing people to prepare for catastrophe.

          1. There are many ways to prepare for catastrophe that don’t involve perpetuating the mess we’re in. Catastrophic health insurance plans come to mind, as do HSAs.

            I’m really liking this view of it: http://theweek.com/articles/68…..are-system

            This author uses car insurance as an analogy to show how ridiculous health insurance (and our perception of healthcare) has become.

            1. Well that analogy was complete nonsense, but I do find the ideas for healthcare very intriguing (I can’t stand Pascal-Emmanuel Gobry, BTW. The first half of the article was all him, and it was bonkers, but when he laid out other people’s ideas it was interesting xD).

              Still, that proposal isn’t “removing 3rd party payers,” which is what I was addressing.

              1. Well that analogy was complete nonsense

                Not really. If the car insurance industry operated like the healthcare industry did, then you’d use your insurance for routine oil changes, you wouldn’t know the price of the procedure beforehand, and the charged cost would be about $2,500 with the insurance company would negotiate it down to “$1,500”, your copay would be about $25, and your monthly insurance bill would be about $500.

                1. Well that analogy was complete nonsense

                  Not really.

                  Really.

                  If the car insurance industry operated like the healthcare industry did,

                  You understand neither … OR why they don’t.

                  the charged cost would be about $2,500 with the insurance company would negotiate it down to “$1,500”

                  That never happens in car insurance, and often happens in health insurance.

                  our copay would be about $25

                  When you move out from mommy and daddy’s car and get your own, you’ll see a wide choice of co-pays and deductibles … and NOTHING called “catastrophic” Same with homeowners – when you’re even older,

                  1. It’s hilarious how you spewed out this whole word salad and didn’t refute a thing I said.

                    1. It’s hilarious how you spewed out this whole word salad and didn’t refute a thing I said.

                      Your very next comment proves you a liar, For those who need proof..

                  2. That never happens in car insurance, and often happens in health insurance.

                    I said “if the car insurance industry operated like the healthcare industry did,” dummy. Try to keep up.

                    1. Behold the psycho liar

                      The lie

                      ME:That never happens in car insurance, and often happens in health insurance.

                      PSYCHO: I said “if the car insurance industry operated like the healthcare industry did,” dummy. Try to keep up.

                      The truth — which is a slight scroll backwards (snicker)

                      PSYCHO: the charged cost would be about $2,500 with the insurance company would negotiate it down to “$1,500”

                      ME: That never happens in car insurance, and often happens in health insurance

                      Still confused?
                      1) I responded to his total bullshit/ignorance regarding negotiated reimbursements.
                      2) That is NOT what he claims I responded to,

                      dummy. Try to keep up

                      Howzat, chump?

                      (My tone and boldface in defense of aggression by an outed gasbag)

                    2. You know what an “if/then” clause in the English language means, right dummy? I’ll spell it out for you–“IF” this occurred, “THEN” this would happen.

                      I never claimed the car insurance industry operated like the healthcare industry did, which anyone with a basic ability for reading comprehension would discern. Here’s the actual phrase:

                      If the car insurance industry operated like the healthcare industry did

                      Please to be showing where I said that they operate in the same manner. Howzat, chump? (floats away chortling)

                    3. Cyber-bully either missed the point entirely.
                      Or he’s just dumb.

                      Please to be showing where I said that they operate in the same manner.

                      (sigh) I never said you did, Sluggo,

                      For any other retards (or liars) he lied about what I responded to, which I corrected.
                      And like I said, scroll back just a bit to confirm the truth.
                      Now he repeats the same psycho lie — without the phony quote. (smirk)

                      (My tone and boldface are in defense of repeated aggression by a serial liar and cyber-bully)

                    4. (sigh) I never said you did, Sluggo,

                      Apparently Mike doesn’t remember what he wrote:

                      That never happens in car insurance, and often happens in health insurance

                      Of course, I never claimed they did, just what would happen if the car insurance industry operated like the healthcare industry. But Mike is so obsessed with “winning” internet arguments that he can’t even keep up with what’s actually being written.

                    5. And you’re a delusional dimwit who can’t admit that he got punked

                      https://reason.com/archives/201…..nt_6790556
                      https://reason.com/archives/201…..nt_6790683

                    6. (yaw-w-w-w-w-n-n-n-n-)

                      Translated from Hihnsanity: “I’m a mendacious liar who can’t do basic research on the internet.”

                    7. Translated from Hihnsanity

                      (yawn)
                      https://reason.com/archives/201…..nt_6790815

                    8. (yawn)
                      https://reason.com/archives/201…..nt_6790495

                    9. Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people.

                      And haters gotta hate.

                      ad ho?mi?nem
                      [?ad ?h?m?n?m]
                      ADVERB
                      (of an argument or reaction) directed against a person rather than the position they are maintaining:

                    10. Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people.

                      And microscopic minds offer insubstantial quotes to disguise their lack of debating skills and reading comprehension. Plus the posting of unsourced data.

                      And haters gotta hate.

                      As Hihnsanity so effectively demonstrates with every post.

          2. Prior to WWII, and for most people for quite a while after, health insurance was just like any other insurance … catastrophic coverage.

            In WWII, with the wage and price freezes in effect, the big manufacturers went to Washington to come up with some benefit they could offer to workers so they could get the best ones. They settled on broad health care “insurance” that would be paid pre-tax as a company expense instead of individuals buying what they felt they needed and could afford on their own.

            The big companies were already unionized and the unions thought that was a great benefit to keep and expand, so the coverage kept getting broader and spreading into more and more of the economy until it became simply an expected almost universal benefit for anything but the smallest of companies.

            *That* is the market that *today’s* health insurance companies were created to serve. *That* and the additions of Medicare (can’t go wrong helping out voters that almost always vote, like older people) put us in the pickle we;re in now.

          3. I’m extremely skeptical, to the point of finding the idea absurd, that health care costs would go down so much without third party payers and government interference that it’d become broadly affordable to the average American.

            Seriously? Healthcare costs WERE affordable–as in, you could pay for most procedures out of pocket–before LBJ signed the Great Society into law and Nixon signed the HMO Act. Sixty years ago, a normal live birth and two days in a private hospital room were about $1,000, inflation-adjusted. When our youngest was born in 2015, the hospital charged $25,000.

            What you’re proposing seems to be a lowering of health care demand by locking millions of people out of the market by not allowing people to prepare for catastrophe.

            If by “catastrophe”, you mean an annual physical, then yes, there’s no reason an average person should need to use insurance to pay for that unless they want to pay the insurance company big dollars for a full comprehensive plan. But an annual physical or any routine healthcare procedure shouldn’t require insurance to pay for it every single time.

            1. Seriously?

              He’s ba-a-a-a-ack!

              Healthcare costs WERE affordable–as in, you could pay for most procedures out of pocket–before LBJ signed the Great Society into law and Nixon signed the HMO Act.

              Nonsense on all counts. And HMOs LOWERED costs substantially.

              a normal live birth and two days in a private hospital room were about $1,000,

              Private rooms had not been used for decades. The average was $600 … which is $5,000 today. If you think people paid cash for that you probably believe it costs $25,000 today!

              When our youngest was born in 2015, the hospital charged $25,000

              OOPS! (lol)
              The average cost of a Caesarean was $16,000, and $10,000 for a vaginal delivery.
              http://www.webmd.com/baby/feat…..g-a-baby#2

              How did Medicare/Medicaid cause a near doubling in constant dollars?

              But an annual physical or any routine healthcare procedure shouldn’t require insurance to pay for it every single time.

              And annual checkups SAVE money, especially in Medicare. It’s called preventive medicine.

              Catastrophic coverage is totally stupid, for the same reason Obamacare is stupid. I’m diagnosed with cancer. Why should I have to pay $6,000-10,000 before insurance kicks in? Stupid for Obamacare but brilliant from Cato ? as goobers in both tribes grin with pride.

              1. If you’re diagnosed with cancer, then I don’t see anything wrong with having you to pay $6,000 to $10,000 before insurance kicks in. It’s a whole lot better than paying the full price, which can easily be $100,000 and even be as high as $2,000,000.

                And do you know what? If I had $50,000,000 in the bank, I wouldn’t worry about paying $2,000,000 for cancer. It wouldn’t be catastrophic for me, in much the same way that paying $2,000 for gallbladder surgery shouldn’t be catastrophic — it would hurt a bit, but it’s something I could absorb — although paying for that, plus a birth, and a couple of other things in a single year just might be, given my current income. Hence, it would be useful for me to have a plan that has a $2,000 deductible, so that when I have three emergencies in my family in a given year, I shouldn’t have to worry too much.

                But when I’m paying $500 a month for a $5,000 deductible plan, I can’t help but wonder: just what am I paying for with my insurance, anyway? I wish I had time to study actuarial science, so that I can give a better answer, but I find it suspicious that I only pay about $35/month for $500,000 worth of life insurance, but health care insurance is much, much more expensive than that…

                1. If you’re diagnosed with cancer, then I don’t see anything wrong with having you to pay $6,000 to $10,000 before insurance kicks in.

                  Even if my income is $25,000 per year? This is why Progressives have been kicking our ass for decades.

                  And do you know what? If I had $50,000,000 in the bank, I wouldn’t worry about paying $2,000,000 for cancer. It wouldn’t be catastrophic for me,

                  That was even worse. Remember, I’m blaming the libertarian elites, not you.

                  But when I’m paying $500 a month for a $5,000 deductible plan, I can’t help but wonder: just what am I paying for with my insurance, anyway

                  Do you get it NOW?

                  I’ll spell it out more. Catastrophic coverage, as proposed by Cato and all the other free-market illiterates, is based on the same distortions caused by the tax preference ? which they also APPEAR clueless about.

                  In a free market, “catastrophic” would have LITTLE OR NO deductible for catastrophic PRODEDURES — but high deductibles, or NO COVERAGEm for routine care. It helps to understand both markets and insurance … which is not possible for anyone dumb enough to believe Medicare Vouchers are “privatizing” because insurance companies would be involved. Umm, insurers would add a costly (and useless) middleman … while increasing competition IN THE WRONG MARKET.

                  Is is tribalism to deny libertarians are just as tribal as the other two? Perhaps even worse?

              2. Nonsense on all counts. And HMOs LOWERED costs substantially.

                Wrong. It lowered the perceived costs. Healthcare costs have been rising at a higher rate than inflation for decades.

                Private rooms had not been used for decades.

                Wrong. Wrong, wrong, wrong.

                The average was $600 … which is $5,000 today

                Wrong. Wrong, wrong, wrong.

                Here’s a comparison of the cost of childbirth today with the cost of childbirth (mine) in 1958. Adjusted for inflation, it was about $1,000 in 1958 and about $10,000 today.

                OOPS! (lol)

                I said for the birth AND two days in a private room, dummy. Try to keep up. The birth procedure all by itself–a vaginal delivery–was in fact charged $10K. The hospital stay itself was $15K. You know how to do basic addition, right? LOL.

                1. Nonsense on all counts. And HMOs LOWERED costs substantially.

                  Healthcare costs have been rising at a higher rate than inflation for decades.

                  But not HMO’s, Sparky. Do you even know what am HMO is?

                  It’s nor nice to pick on the handicapped. You’re already a proven liar on this page … twice … and already full of shit on this one. Then again, you may be crazy enough to think all our healthcare is provided by HMOs.

                  What a pathetic blowhard.

                  OH WAIT!!!

                  the birth procedure all by itself–a vaginal delivery–was in fact charged $10K. The hospital stay itself was $15K. You know how to do basic addition, right? LOL.

                  (snicker) LOOK AT THE HOSPITAL BILL AT YOUR OWN MOTHER JONES LINK!!!! (lol)

                  1. But not HMO’s, Sparky. Do you even know what am HMO is?

                    Government interference in the healthcare market.

                    It’s nor nice to pick on the handicapped. You’re already a proven liar on this page … twice … and already full of shit on this one.

                    Which you’ve never refuted with actual data, so you’re just blowing smoke here. If you have proof that HMOs have lowered the real cost of healthcare by a net amount, you’re welcome to show the proof.

                    (snicker) LOOK AT THE HOSPITAL BILL AT YOUR OWN MOTHER JONES LINK!!!! (lol)

                    And he falls into the trap, LOL.

                    From the link:
                    Here’s a comparison of the cost of childbirth today with the cost of childbirth (mine) in 1958. Adjusted for inflation, it was about $1,000 in 1958 and about $10,000 today.

                    Final charges, which included two days in a private room (note the bill also says “open room” on the last day) with the $40 credit included, were $108.46. In 2017 dollars, that’s $874.27. Take out the $40 credit, and the inflation-adjusted cost was $1,196.

                    1. What Hihnsanity said:

                      The average was $600 … which is $5,000 today. LOL–for someone who screams about liars, you have a pretty bad problem with the truth yourself.

                      What I said:
                      Sixty years ago, a normal live birth and two days in a private hospital room were about $1,000, inflation-adjusted.(Note: Which the Mother Jones link confirmed, LOL) When our youngest was born in 2015, the hospital charged $25,000. Hihnsanity tried to distort it by cherry-picking the vaginal birth procedure only, which makes him a liar. (Twirls away snickering)

                    2. See the dumbass

                      Do you even know what am HMO is?

                      Government interference in the healthcare market.

                      (laughing harder)

                    3. What’s truly funny was your lie that the average was $600.

                    4. Here’s what Hihnsanity apparently is unable to read:

                      https://reason.com/archives/201…..nt_6790692

                      From the link:
                      Here’s a comparison of the cost of childbirth today with the cost of childbirth (mine) in 1958. Adjusted for inflation, it was about $1,000 in 1958 and about $10,000 today.

                      Final charges, which included two days in a private room (note the bill also says “open room” on the last day) with the $40 credit included, were $108.46. In 2017 dollars, that’s $874.27. Take out the $40 credit, and the inflation-adjusted cost was $1,196.

                      Hihnsanity claimed that the average was $600:
                      https://reason.com/archives/201…..nt_6790560
                      But he offered no evidence. That makes him a liar.

                    5. But he offered no evidence. That makes him a liar.

                      (yawn) Accuses with no evidence. Thug,

                    6. (yawn) Accuses with no evidence. Thug,

                      Here’s where Hihn’s lies were jammed up his ass. Loser.
                      https://reason.com/archives/201…..nt_6790656

                      Best part is he still hasn’t shown where the Mother Jones poster’s childbirth bill said “co-pay”, but claims that it was a co-pay, without evidence. The mark of an insane, delusional liar who can’t admit that his reading comprehension is shit. Sad!

              3. How did Medicare/Medicaid cause a near doubling in constant dollars?

                Gee, you think it’s a coincidence that the costs of healthcare started rising faster than inflation after these programs and the HMO act (not to mention EMTALA) passed into law, followed by Obamacare which has contributed to $1.4 trillion in costs for Medicare/Medicaid services? For a libertarian, you seem to be pretty clueless about how government interference distorts markets.

                1. How did Medicare/Medicaid cause a near doubling in constant dollars?

                  Gee, you think it’s a coincidence that the costs of healthcare started rising faster than inflation after these programs

                  Not a coincidence. But I won;t pull a cause out of my ass like you.

                  followed by Obamacare which has contributed to $1.4 trillion in costs for Medicare/Medicaid services?

                  Now you switch from your original bullshit on costs for specific procedures … to the total healthcare costs for everything!!!

                  1. Not a coincidence.

                    Thanks for confirming I was right, LOL.

                    Now you switch from your original bullshit on costs for specific procedures … to the total healthcare costs for everything!!!

                    “microcosm: a community, place, or situation regarded as encapsulating in miniature the characteristic qualities or features of something much larger.”

                    1. Not a coincidence. But I won’t pull a cause out of my ass like you.

                      Thanks for confirming I was right, LOL.

                      (smirk)

                    2. See the dumbass

                      Do you even know what am HMO is?

                      Government interference in the healthcare market.

                      (laughing harder)

                    3. See Hihnsanity

                      Private rooms had not been used for decades. The average was $600 … which is $5,000 today. If you think people paid cash for that you probably believe it costs $25,000 today!

                      https://reason.com/archives/201…..nt_6790656

                      (chortles gleefully)

        3. Perhaps I’m naive, but why not just allow healthcare providers to set their own prices?

          Many have been doing so for at least 15 years, offering “discounts” as high as 50% for cash. Also concierge treatment.

          We all know …

          Only the uninformed “know” that.

          If we remove the 3rd party payors, then healthcare providers could completely reevaluate their actual costs & provide consumers with accurate prices which they could use to shop around & find the best deal.

          You want me to shop around for the best deal on … heart bypass? Childbirth?

          But to dismiss the entire idea because some doctors would overcharge

          Again, only the uninformed would (I hope)

          1. So if only the uniformed “know” that, please inform me.

            And yes, I do suggest you shop around for the best deal on childbirth. Childbirth tends to be something where you get 8 or so months of notice beforehand.

            1. We all know that the insurance companies have caused healthcare pricing to not only increase but to become convoluted to the point that no one knows what anything actually costs

              Only the uninformed “know” that.

              So if only the uniformed “know” that, please inform me.

              I just did, And since you don’t know the problem, you can’t know a solution.

              You want me to shop around for the best deal on … heart bypass? Childbirth?

              And yes, I do suggest you shop around for the best deal on childbirth.

              But not bypass.
              How can we do that without something fucking stupid, like the current version of catastrophic coverage. A woman gets pregnant. Why should she have to spend $6,000 or so before the insurance kicks in? Especially for low-incomes where catastrophic coverage is just as stupid as Obamacare. And why do “we” ridicule Obamacare for high deductibles, then call for the same thing?

              What is the libertarian establishment too STUPID to know that the entire mix of HSAs and catastrophic is justified ONLY if we keep today’s crazy tax preferences?

          2. Shop around for health care? You mean like everyone used to? What a novel idea!

            1. Shop around for health care? You mean like everyone used to? What a novel idea!

              (lol) Now explain HOW it can best be done to Cato and the other dipwads. Especially with Medicare, where they TOTALLY screw up! VOUCHERS????? (OMG)

            2. Nobody really “shopped” for healthcare. Most either got it from their employer or a government program, so only about 10-20% of the population “shopped around”.

      3. We will *never* be able to give everyone every treatment that could possibly benefit them.

        The first lesson of economics is scarcity: There is never enough of anything to satisfy all those who want it. The first lesson of politics is to disregard the first lesson of economics. – Thomas Sowell

        1. We will *never* be able to give everyone every treatment that could possibly benefit them.

          Why not? (Assuming a justifiable price )

          The first lesson of economics is scarcity:

          Learn the others. And you’ve confused “benefit” and “want”

          There is never enough of anything to satisfy all those who want it. The first lesson of politics is to disregard the first lesson of economics. – Thomas Sowell

          You can paste, but can you explain what it means? He’s explaining the role of prices, but contradicts the Law of Supply and Demand — which would clearly enrage the Milton Friedman who launched Sowell’s career,

    2. Sure, but “the idea…at the very heart of the problem” is in firm control of the whole world’s population, and is likely to be made moot?by the entire popul’n’s becoming so rich that scarcity ceases?before it ever loses its grip. Yes, I’m saying it’ll be easier to become fabulously wealthy than to make significant progress against this tide of thought. In the meantime only 2nd-best partial remedies are worth pursuing.

      1. Actually it might not require fabulous wealth overall, but enough in this specialized field so everybody will have a robot doctor taking care of them.

  5. Halting federal funding of the nation’s largest abortion mill is a victory.

    For the fascist element of the religious right. And that’s the same deceptive language that causes so many to believe government pays for abortions. Abortion MILL? Shameful.

    PP’s federal funding consists comes mostly for Medicaid. Plus Title X family planning (since President Ford) which has slashed abortions by inner-city teens, as intended.

    PP is the SOLE provider for millions of inner-city women (who are only black anyhow). Because Medicaid pays much less than Medicare, many inner cities have no doctors at all (not enough private insured to overcharge and offset Medicare/Medicaid losses).

    Many supporters claim public health clinics can replace PP (admitting the funds do NOT pay for abortions). The clinics are there … but OBVIOUSLY not the needed physicians, and we have a growing nationwide shortage of primary care physicians.

    Craziest of all, the lie that federal-finding pays for abortions because “money is fungible.” Abortion is profitable, Medicaid is not. Which of the two is subsidizing the other (DUH) The ONLY reason Planned Parenthood can accept Medicaid is because … abortions pay the clinic overhead. Jr. high math. Medicaid does not cover fixed overhead … which is WHY the doctors aren’t there. Simple math.

    1. So just to be clear. You’re advocating for government subsidization of a private firm, on a libertarian website? It doesn’t matter if the firm performs abortions or sells cute baby kittens. It shouldn’t get subsidies, period.

      1. Yeah, the argument over whether PP is re-allocating federal funding on the sly for abortions, from a libertarian perspective, shouldn’t even be relevant. What’s relevant is whether they should actually receive federal funding at all.

        I guess if one believes that abortion is a legitimate government function since it helps keep down the population of low-IQ inner-city youfs to a manageable level, and thus keeps down the cost of all the social welfare programs that they can take advantage of, that’s one thing. But I have a hard time seeing why libertarians should be the ones making that argument.

        1. No one is discussing ending Medicaid payments to all providers, so that hardly seems relevant.

          1. No one is discussing ending Medicaid payments to all providers, so that hardly seems relevant

            Yeah, but primary healthcare providers have a choice as to whether they will accept Medicare/Medicaid. If PP can’t operate without Medicaid funding, as Hihn seems to be alluding to above, then it raises the question as to where all those donations that PP receives every year are going towards. This is a non-profit org that raises hundreds of millions in private donations but spends over $1.2 billion a year. It would be interesting as to what an audit of their accounts would reveal.

            1. If PP can’t operate without Medicaid funding, as Hihn seems to be alluding to above

              Are you really that illiterate? Hihn’s claim is that PP’s abortion work subsidizes its Medicaid patients.

              The problem he is claiming from stopping Medicaid payments to PP is that…Medicaid patients won’t get care.

              1. The problem he is claiming from stopping Medicaid payments to PP is that…Medicaid patients won’t get care.

                One more time: The clinics are there, but they have no doctors for this … unless you think thousands of doctors are sitting around in inner-city public health clinics … masturbating to porno websites … because they have no patients. So who has the problem here?

                Funding is determined by patients — selecting their provider. Who are you to deny their free choice? Oh wait, they’re only black.

                Consider the moral atrocity here. So-called Christians want to punish a nonprofit for performing a constitutionally protected medical procedure — paid entirely by private dollars — that will not prevent a single abortion … but will destroy the sole medical provider for millions of inner-city women … mostly black.

                And some say that only liberals are easily brainwashed!

                1. When I was a poor broke teen/20’s, there were plenty of private free clinics around. PP was only one of many. Since governments at various levels have been funnelling more and more funding through PP, all those other free clinics have disappeared.

                  And non-profit doesn’t mean there aren’t people making out like bandits in them. It’s just a tax classification based on whether there is anything to be distributed to owners. It doesn’t say anything about salaries and benefits paid to people who work there.

              2. If PP can’t operate without Medicaid funding, as Hihn seems to be alluding to above

                Are you really that illiterate?

                Scrolling down the page suggests ignorance combined with gullibility, as we see in both auto and health insurance. Plus a blatant lie on the costs of childbirth.,

                Hihn’s claim is that PP’s abortion work subsidizes its Medicaid patients

                Which is WHY they lie about fungibility..(Technically, paying the overhead is not a subsidy, but a cost reduction for Medicaid at no additional expense to PP)

                1. Scrolling down the page suggests ignorance combined with gullibility, as we see in both auto and health insurance. Plus a blatant lie on the costs of childbirth

                  LOL–you really suck at doing basic research on the internet. Here’s a helpful hint: Google “Average cost of childbirth in 1955”

                  1. Here’s where Red Rocks bullshit on auto and health insurance was jammed up his ass

                    https://reason.com/archives/201…..nt_6790556

                    Hey, he BRAGS about baiting and inciting people, But he’s NOT a thug?????

                    1. Here’s where Red Rocks bullshit on auto and health insurance was jammed up his ass

                      Here’s where Hihnsanity’s lies (or inability to read, same difference) about what I wrote were jammed up his ass:

                      https://reason.com/archives/201…..nt_6790683

                      Hey, he BRAGS about baiting and inciting people, But he’s NOT a thug?????

                      Hey Mike, stop making bullshit claims about childbirth procedures costing $5,000 inflation-adjusted 60 years ago and I won’t have to keep smacking you around–loser.

                    2. 1) This is an inflaton adjuster.
                      http://www.usinflationcalculator.com/

                      2) Enter the years. 1960 on top, 2017 on bottom
                      3) Enter the amount $600 (which is for 1960)
                      4) Press the blue button labeled “calculate” (for what $600 is worth today)
                      5) See $4,992, 41.– in bold to help retards.

                      Hey Mike, stop making bullshit claims about childbirth procedures costing $5,000 inflation-adjusted 60 years ago and I won’t have to keep smacking you around–loser.

                      Laugh at the bullshitting bully,

                    3. Laugh at the bullshitting bully,

                      The Mother Jones link showed a cost of $108, dummy. You have any proof that the average cost was $600 in 1958?

                    4. The Mother Jones link showed a cost of $108, dummy

                      (smirk) That’s the patient’s bill. It’s called the ….. CO-PAY.

                      Average cost of childbirth in 1960 = $600
                      http://www.answers.com/Q/The_a…..0?#slide=2

                      Your Mother Jones link for current average (lol) )
                      Average Cost of Childbirth Today (large 50 point type)
                      United States …. $9,775 (snort)

                      Check the fine print INCLUDES THE HOSPITAL ROOM!! (OMG)

                    5. (smirk) That’s the patient’s bill. It’s called the ….. CO-PAY.,

                      Hihnsanity lies about MUH CO-PAY because he knows he’s caught dead to rights. Show where it says “co-pay” on the bill, dummy.

                      Average cost of childbirth in 1960 = $600

                      A wikianswers link with no supporting evidence. Try again, dummy.

                      Check the fine print INCLUDES THE HOSPITAL ROOM!! (OMG)

                      OMG indeed–at Hihnsanity’s inability to read:

                      Sixty years ago, a normal live birth and two days in a private hospital room were about $1,000, inflation-adjusted.

                      https://reason.com/archives/201…..nt_6790495

                      LOL

        2. I guess if one believes that abortion is a legitimate government function since it helps keep down the population

          Yes, total retards are always a problem. But most of us have no problem ignoring their bullshit.

          1. Yes, total retards are always a problem

            Well, sure, go to inner-city schools and they’re ubiquitous.

            1. Yes, total retards are always a problem. But most of us have no problem ignoring their bullshit.

              Well, sure, go to inner-city schools and they’re ubiquitous.

              I meant you as the retard, for thinking ANYONE believes the bullshit of the wacko right.

              1. For someone who claims to have no trouble ignoring them, you sure have a problem not trying to get in the last word.

                1. Now the fucking bully is pissed that I EXPLAINED what he was too dumb to read..

                  The lout who brags about baiting and inciting people. How many people beat their chests with pride … at being a thug and aggressor?

                  1. Now the fucking bully is pissed that I EXPLAINED what he was too dumb to read..

                    Here Hihnsanity loses his shit and projects his inability to read on to me.

                    1. Here Hihnsanity loses his shit and projects his inability to read on to me

                      (yawn) https://reason.com/archives/201…..nt_6790815

                    2. Here Hihnsanity posts a link that doesn’t do anything to refute his inability to read.

                    3. Here Hihnsanity

                      (yawn)
                      https://reason.com/archives/201…..nt_6790815

                      ad ho?mi?nem
                      [?ad ?h?m?n?m]
                      ADVERB
                      (of an argument or reaction) directed against a person rather than the position they are maintaining
                      (smirk)

                    4. (yawn)
                      https://reason.com/archives/201…..nt_6790495

                      LOL

                    5. Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people.

                      And haters gotta hate.

                      ad ho?mi?nem
                      [?ad ?h?m?n?m]
                      ADVERB
                      (of an argument or reaction) directed against a person rather than the position they are maintaining:

                    6. Great minds discuss ideas.
                      Average minds discuss events.
                      Small Minds discuss people.

                      And microscopic minds offer insubstantial quotes to disguise their lack of debating skills and reading comprehension. Plus the posting of unsourced data.

                      And haters gotta hate.

                      As Hihnsanity so effectively demonstrates with every post.

      2. Medicaid payments go to the private firms that provide care.

        This is no different in that regard

        1. Medicaid payments go to the private firms that provide care.

          Correct

          This is no different in that regard

          What’s your solution?. Mine were proposed roughly a quarter century ago. Here and here.. Also see “Reinventing Federalism” under Governing.

          “Git gummint out” is not a solution .. especially in a country that governs under “The Will of The People,”

      3. So just to be clear. You’re advocating for government subsidization of a private firm, on a libertarian website?

        Just to be clear, you’re confused. I merely showed how stupid the GOP plan is.

        It doesn’t matter if the firm performs abortions or sells cute baby kittens. It shouldn’t get subsidies, period.

        You have no clue how to restore the 100% treatment we used to have in America — and what Americans wanted because they paid for it.. Period.

        You may also assume (falsely) that anti-gummint is the only form of libertarianism. It’s a tiny minority. It takes a LOT of gall to ignore “Will of The People” without a dictatorship.

        Pro-liberty libertarians are totally focused on how to better achieve what most Americans want. Anti-gummint libs are clueless there also, and even ridicule the notion of actual solutions.

        A large majority of people want at least 95% of want government provides. That’s only because libertarians TOTALLY failed at defending a better alternative, and also propose NO credible solutions for … anything, (except a VERY narrow range of things that can simply be repealed)

        1. We agree on one thing. The GOP establishment plan is horrible.

          1. As are all the GOP alternatives.

        2. We never had 100% treatment for everyone for everything. Never have, never will.

          The will of the people is how close can they get to obtaining everything they want with someone else paying for it. Always has been, always will be.

          “The State is that great fiction by which everyone tries to live at the expense of everyone else.” – Bastiat

          TANSTAAFL

          1. We never had 100% treatment for everyone for everything. Never have, never will.

            Leara the history of charity hospitals .. instead of spouting memorized slogans (on a different topic).

            The will of the people is how close can they get to obtaining everything they want with someone else paying for it. Always has been, always will be.

            Why do you have such hatred for humanity? Even this atheist suggests you study Jesus Christ … deeply … for at least a year.

            “The State is that great fiction by which everyone tries to live at the expense of everyone else.” – Bastiat
            TANSTAAFL

            If all one has is memorized slogans, then they often insert them where they do not apply. For example, you’ve just confused private charity with government welfare.

    2. Have you ever stopped to think why doctors don’t want to practice in inner cities?

      1. Have you ever stopped to think why doctors don’t want to practice in inner cities?

        For the reason I described.

        1. Or perhaps because they want to make a lot of money since they invested in 10 years of school.

          1. timbo|3.10.17 @ 11:04AM|#
            Or perhaps because they want to make a lot of money since they invested in 10 years of school.

            Even shoeshine boy can’t operate at a loss.
            But The Bern will give you a cookie for saying that.

    3. If this were important to PP they would spin off their clinics from their abortion mills.

      1. If this were important to PP they would spin off their clinics from their abortion mills.

        In your dictatorship. But then they could no longer afford to do Medicaid! You realize that abortions are 3% of their procedures, right?

    4. PP is a horrible provider. Cannot even do mammograms. Free clinics are plentiful and always need more funding. Fund THEM instead.

      1. PP is a horrible provider.

        How would you know?

        Cannot even do mammograms.

        The machines are too costly for their number of patients, so they do referrals — like most clinics. My metro area (Boise) is only about a half-million people. We have TWO providers of mammograms — our largest of two hospitals (not the 2nd one) and a provider that does nothing but imaging.

        They perform all other breast cancer screenings — roughly a half-million per year.
        The bullshit claims of Breitbart and their ilk were demolished by Politifact and many other credible fact-checkers

        Free clinics are plentiful and always need more funding. Fund THEM instead.

        Aren’t you the clever fascist. The funding is determined by the PATIENTS. Who are you to deny them their choice of providers?

        1. reason.com Republican posing as a free market libertarian

    5. PP is the SOLE provider for millions of inner-city women

      You haven’t been in the inner city much, have you? This is the same BS as the “food desert” nonsense.

      1. PP is the SOLE provider for millions of inner-city women

        You haven’t been in the inner city much, have you?

        Why would I have to. I can read,3

        1. So you have no idea what you’re talking about; thanks for confirming that.

          1. So you have no idea what you’re talking about; thanks for confirming that.

            Actually, I was ridiculing your statement. As I am this one.

            Do you know who “discovered” America? WERE YOU THERE?
            (smirk)

  6. Human beings have a basic human right to free healthcare. And free food, housing, education, a good job at a good wage, childcare, retirement income, support if they’re old or sick or handicapped or just plain fat, stupid and lazy, and a whole host of free stuff to enjoy the standard of living entailed in a minimally decent quality of life. Nobody should be forced to endure a below-average quality of life, we shouldn’t rest until the government guarantees an above-average life for everybody. In this, the richest nation ever to exist on Earth, there’s simply no excuse for not ensuring that every single one of its citizens is above average. How can you possibly justify the morally outrageous situation where people who are better off than other people are better off than other people simply because they’re better off than other people? Everybody deserves to be better off than everybody else.

    1. Jerry,
      I think you just recited the stump speech of:
      Castro, Mao, Stalin, Ho, and Kim.

      No wait, they just killed millions using that premise. No need to stump when you can just murder and plunder.

    2. “Everybody deserves to be better off than everybody else.”

      Everybody I know is above average!

      1. I see some really nice cars in the projects and a lot of flat screens in bad neighborhoods. Are the poor and unfortunate in American really having that bad of a life?

        Most of them are living better then 20 year olds starting out in life.

        1. I always liked Thomas Sowell’s answer to Jane Fonda’s complaints about poverty in America when somebody pointed to the homeless in New York City sleeping on steam grates and bathing in public restrooms and scrounging food out of dumpsters – in truly poor countries there are no steam grates to sleep on or public restrooms to bathe in or dumpsters to scrounge food out of. Poverty, disease, violence – that’s the natural state of Man in nature. The question isn’t why some people still have to endure a life of wretched misery, the question is how have some managed to escape it? Capitalism and the free market provide unequal benefits, but they provide benefits to everybody. It’s the worst system we could come up with, except for everything else human beings have ever tried.

          1. somebody pointed to the homeless in New York City sleeping on steam grates and bathing in public restrooms and scrounging food out of dumpsters

            Those people are almost entirely made up of mentally ill folks who refuse the generous assistance provided by the city at enormous cost to the productive class.

          2. Bingo Jerry.

            Washington DC read what you just said once and passed out. Then they woke and ran for office knowing they could sell the exact opposite.

            Marxism and government provide equal benefits and they afford that benefit to all by ………………………..well your kids can worry about that.

        2. I see some really nice cars in the projects and a lot of flat screens in bad neighborhoods

          You run around the slums, peeking into their windows?
          Do you also reject YOUR massive tax subsidy paid by the rich?

    3. Human beings have a basic human right to free healthcare.

      NEVER do satire — even blatant satire — to this commentariat!

      1. That’s not satire. Tony said that exact same thing, I think verbatim, yesterday.

        1. Then they’re both satire. duh

  7. I agree the plan sucks, but it does repeal the individual mandate. That makes up for a lot of the shittyness, IMO. The individual mandate is a horrible abomination.

    1. Yeah but how is that different than requiring auto-insurance? I mean we don’t really have the option *NOT* to drive a car, especially since

      1. stupid squirrels.

        … especially since *insert hometown here* does not spend enough on public transportation, so I am FORCED to drive a car!

        / prog derp

        1. What stops someone dfrom buying a fleet of buses and offering mass transit?

          1. The fact that only poors are expected to ride them so you can’t charge enough to make a profit?

            1. Where I used to live in Southern Indiana there was a private bus company that did quite well for itself taking over where the public one failed.

    2. Yeah but how is that different than requiring auto-insurance? I mean we don’t really have the option *NOT* to drive a car, especially since

      1. Because driving a car around other people imposes risks on them.

        1. Every interaction with others necessarily involves some risk. That, in no way, implies that auto insurance is necessary.

          There are necessary laws (for public roads) that clearly outline under what conditions someone is responsible for the damage caused in an accident. Being responsible in no way means that a company that you do not own has to pay for the damages caused by the accident. The only thing preventing you from paying instead of an insurance company is the law. In fact, the more you actually think about it, the less it makes sense to mandate car insurance.

    3. You know what else would repeal the individual mandate? Repealing the whole thing.

      Of course, if the Supreme Court would just do its job, the whole thing would already be gone. If part of a law is unconstitutional, then the whole thing is and it should be invalid. If congress doesn’t like it, then they can make more narrowly focused laws.

      1. If part of a law is unconstitutional, then the whole thing is and it should be invalid.

        That is a massive contradiction of … yourself.

      2. “Of course, if the Supreme Court would just do its job, the whole thing would already be gone.”

        If the Supreme Court had been doing it’s job all along about 95% of what government is doing now would have been ruled unconstitutional before it ever got started.

        Every single law predicated on the bogus expansionist interpretation of the interstate commerce clause would never have been enacted.

        Social Security, Medicare, Medicaid, food stamps, etc. etc. would never have been enacted as they are not pursuant to any enumerated power delegated to the federal government in the text of the Constitution as is required by the 10th Amendment.

        1. That would also ban most of Ron Paul’s wacko agenda on marriage equality, abortion, etc. Unless we all join him in pretending the 9th Amendment does not exist!

          1. The government has no business having anything to do with marriage. Nor should it have anything to do with abortions or any of the vast majority of things it’s been sticking its nose into for the last 100 years or more.

    4. I think they’ll need to get a few Democrats on board. Republicans do not have a filibuster-proof Senate majority. This brings up the question as to how Democrats go the ACA through using reconciliation. I’d think the same gimmicks would be necessary to undo it.

  8. Let me know when Republicans truly disavow socialist medical programs. Where is the clamoring among patriotic, free-market Republicans for the repeal of Medicare? Is that off the table because Obama didn’t invent it?

    1. People become pretty socialistic when their wallet is impacted.

      Never mind that they should save and plan for contingencies….like the fact that our government will fail.

      1. You could repeal Medicare if they cashed out the beneficiaries at their projected rate of return.

    2. Where is the clamoring among patriotic, free-market Republicans for the repeal of Medicare?

      Where’s a PLAN for doing so. Ooops. Nobody has one.

      1. So maybe it’s time to set one out for the elimination of *all* entitlement programs.

  9. I don’t understand how anyone can defend Obamacare. It has failed in its stated mission: Lower Costs, Higher Quality, if you like your doctor you can keep your doctor. All those were a lie.

    I guess if your feelings are all that matter then it’s working great. Go team blue!

    1. Slightly more people were covered, though.

      1. To quote an acquaintance: “None of that matters. My friend with a pre-existing terminal condition was able to buy an insurance policy. Obama is a saint.”

        1. Another thing scarcely mentioned is that the chronically ill experienced a “race to the bottom” in terms of quality thanks to the pre-existing condition rule.

          Basically, the pre-existing mandate allows people to switch into whatever insurance currently offers the best coverage for their particular ailment. So everyone with a chronic condition immediately moved to the best deal whenever they could, choked out that coverage, and that insurance program was forced to be taken off the market.

          Over time, we’re simply left with absolute shit coverage for everyone.

          So, yeah. You get your pre-existing condition covered. With the absolute worst possible quality.

          1. I’m still waiting for “pre-existing conditions” to be applied to other insurance as well.

            My Dad died several years ago. We need to get life insurance for him!

            My car was just in an accident. I need pre-existing coverage for auto insurance!

            My home was flooded before it caught on fire. Isn’t it the perfect time to get pre-existing condition insurance for my house?

            Heck, why limit it to insurance? I have the right to claim pre-existing lotto numbers, and when I visit the casino, I should be able to place bets in poker, black jack and roulette *after* I see the cards or after the wheel has spun!

            I can’t possibly imagine *anything* horrible going wrong when we require covering pre-existing conditions for insurance, or for probability-based activities in general! Nope, nothing whatsoever. I’m just *confident* that all these insurance companies and casinos are just *waiting* to pay out on all this pre-existing conditions stuff!

          2. Basically, the pre-existing mandate allows people to switch into whatever insurance currently offers the best coverage for their particular ailment.

            No even close to the real issue.

            It’s not about switching, it’s about buying the insurance only after I’m sick. At an admitted extreme, a woman could buy health insurance in her eight month of pregnancy, cancel it six months after the birth. Repeat the same thing as often as she wants … and pay the same monthly premium as a woman with the same number of kids, who always had coverage.

            So who pays for all the births by the first woman? Everyone else. Guess what? Nobody cares. Well, hardly anyone. If they don’t pay it in higher premiums, they pay it in taxes toward a high-risk pool.
            As long as they believe that denial is a scam to increase insurance profits — which nobody directly refutes — that will never change. I’ve tested it for decades of one-on-one.

            If I use the burning house analogy they think I’m, nuts. If I go one step further, a neighborhood all wth one insurer, then the only uninsured house burns down, who pays for the new house, THEN they get it!

            It’s ALWAYS best to have people answer a direct question, in their own mind, then to spout memorized slogans and soundbites. Persuasion 101. People like Michael Cloud and I have been saying that for over three decades,

  10. So why don’t they just ram through whatever they want like the Dems did when they passed Obamacare in the first place. Not a single GOP vote for that, and several Democratic defections too

    1. Umm, because it was a massive fucking failure for Democrats!

      In today’s world with warring tribes of goobers. both tribes miss the point. ANY major legislation that passes by one or a few votes will be massively divisive among the populace. Forever.

      But that doesn’t matter. Each tribe, like a street gang, THINKS they can have it all their way … and that they DESERVE to.

      It’s like abortion and climate change, among others, Both extremes are dead wrong. but they BELIEVE. And they demonize the other extreme as … satanic or socialist (same thing).

  11. So why don’t they just ram through whatever they want like the Dems did when they passed Obamacare in the first place. Not a single GOP vote for that, and several Democratic defections too

    1. God damn squirrels have infected me today

    2. On Wilkow’s show, he referred to Paul Ryan as a trans republican . Basically a democrat who insists on identifying as a republican. He wants it to say R on his driver’s license, he wants to us the R bathroom, but then gets upset when he is on a fate with another R and they are offended with his democrat bits. Insisting on treating him as a democrat.

      So I guess I’m transphobic.

      1. Nah, it’s the ones with principles who are the freaks.

      2. What/who exactly is a Republican at this point? Trump shat on a bunch of things the GOP supposedly stood for, yet he won the nomination and the presidency.

        1. What “exactly” is a member of any large political party at any point? You can’t get huge #s of people to agree on anything, let alone a bunch of things at once. Yet it’s said that the separation of opinions between the major parties in the USA is the widest it’s been in many decades.

          1. Yet it’s said that the separation of opinions between the major parties in the USA is the widest it’s been in many decades.

            A growing majority of Americans has abandoned loyalty to both major parties … which leaves mostly zealots and fanatics. That’s also why candidates no longer run to the middle for the general election. Essentially, we’re now governed by a minority — until we abandon partisan primaries.

        2. If you listen to a lot of the more extreme conservatives, the majority of Republicans in Congress are RINOs (Republicans In Name Only), which of course does not make a whole lot of sense.

    3. The Republicans don’t have 60 votes in the Senate, that’s why. They’re limited pretty significantly by that.

      1. BINGO. Procedures limit what they can pass with a simple majority — which excludes many of the worst parts of Obamacare. For now. They’re gambling they can put off the least popular parts until the end, when they’ll need 60 votes, and HOPING the Dems will fold … like the GOP never did under Obama! Kinda stupid as a strategy. But they have all those bullshit campaign promises that were never possible.

        1. I thought Democrats lost the 60 votes in the Senate with Scott Brown’s election and so had to use reconciliation instead of just being able to pass it outright.

  12. all of these bills ignore the elephant in the room- prices by health care providers.

    we do not use auto insurance to pay for oil changes and brake pad replacements because the costs are reasonable.

    What we need are strong price controls like Japan has.

    1. Price controls work really well.

      I remember when price controls of rents in new York city resulted in new investments in maintenance and repair in old buildings.

      Or when price controls in sugar and other agricultural commodities resulted in new competition coming to market with better innovations and lower prices to the consumer.

      1. And of course, price controls keep prices low, making health care affordable.

        1. Well who pays for the unintended consequences of price controls then?

          There is inflation, wages, capital costs, population migrations, research and development, new diseases, technological advancements and investments, displacement of labor, insurance and benefit burden to employees.

          What about all of those people working in the healthcare field who have the gall to want to make more money as their career advances and that have the temerity to want to improve their lives by harder work and more achievement?

    2. Price controls won’t do it, but deregul’n will…but only for the “routine” things we unnecessarily see MDs for. For the really big stuff, it’s going to be expensive because there will be few who can do them. And few will be capable of doing them because the volume of biz doesn’t justify having a brain surgeon on every corner. Still deregul’n is worth pursuing because those routine costs, while not the major part of the world’s bill for medical care, are still significant. And when you factor in semi-routine stuff like delivering babies, the benefits to deregul’n are even greater.

      1. It’s like undertaking; you’re going to need their service exactly once. You could never increase the demand to make it a high enough volume biz to get prices down.

    3. The costs are reasonable because the people who use them are the same people as those who pay for them so they price shop and check prices *before* they have the work done. Because auto shops aren’t controlled by the government so they *have* to actually *compete* with each other in giving the best service for the lowest price. If you want to get an insurance policy to cover your everyday car needs, ring up Lloyds of London. They’ll insure just about anything … for a price that will be something more than they statistically expect their payouts to be.

  13. The AHCA is also known as the “Polish the Turd Act”…..

    The subsidy was replaced by a tax credit, which is a fancy name for a subsidy. Other provisions are similar, same as the ACA but sporting different color eyeliner. Obama gave us a pig, and the Republicans are replacing that pig with a different pig. With makeup.

    1. As long as you can get insurance once you get sick, the checks and balances should work out.

      I can see a lot of companies getting on board with being forced to sell a product without a profit.

      1. Why not expans the AHCA to cover all types of insurance?

        1. I everyone could just get paid more then the government could tax more people to pay for insurance coverage for everyone.

    2. Trump looks shiny enough.

    3. Republicans boxed themselves into a corner … with bullshit political promises that were impossible to achieve. They’re now in the process of destroying themselves (again) — because they’re not as big a bullshitter as Trump. (nobody on earth is)

      For example, repealing the mandate to purchase — but keeping the mandated coverage of pre-existing conditions is GUARANTEED to create higher premiums than Obamacare — to anyone who passed 7th grade math.

      The mandate was demanded by the insurance industry, in return for their accepting guaranteed issue — announced between Obama’s election and inauguration.

    4. No, a tax credit is your own $; a subsidy is other people’s $. (Not refundable credits, which aren’t really necessarily tax credits at all, but just plain credits.)

  14. Lurking in on a progs facebook feed — they all hate obamacare but because it doesn’t prog hard enough. This is why you can never reason with these people, no matter how failed their ideology is, they can never accept responsibility. its always someone else’s fault. Like Venezuela blaming the ‘evil capitalists’ —- as long as there is some corporation somewhere, or some republican somewhere, it’s all their fault

    1. One of them blamed the insurance companies, not Obamacare, for the rise in insurance premiums.

      1. Nameless Progressives on Facebook blaming insurance companies for raising rates?

        How silly!

        Smart libertarians at reason.com are doing the wave over a plan they have no idea of the costs which do not matter, obviously.

        1. Who is doing the wave over a patched up subsidy driven boondoggle that will not only implode but also create debt loads that will saddle generations to come?

          Anyone with a brain knows that total repeal is the only hope to possible right the ship of a massive socialist program that was the inevitable outcome of other massive socialists programs such as social security, medicare, medicaid and the prescription drug benefit.

          Abandoning free markets in the name of security is reaping its consequences.

          1. Anyone with a brain knows that total repeal is the only hope

            A massively retarded brain. Yeah, go directly against the will of the people!!!

            Americans want treatment for everyone, for everything. and actually paid for it. The REAL hope is transitioning back to that — showing how to better deliver what people have always wanted. The libertarian elites can’t even do THAT. Many have no clue of how Americans treated everyone, with voluntary payment. How useless.

            1. Well, no. We didn’t pay for it. That’s why we’re almost $20 TRILLION dollars in debt and rising.

  15. If they’re gonna replace the subsidies with subsidies by a different name, why not at least have the guts to make it a part of something more impactful, such as a replacement of Medicaid? That could actually be a substantial positive change, rather than the window dressing changes here.

    1. They will.

      1. No they’re not. At most they might roll back Medicaid expansion somewhat. That’s about it.

        1. Which would virtually guarantee a Democrats sweep next year.

        2. It would be quite victory for Republicans to roll back Medicaid expansion (the grandfathering provision won’t have much impact) and shift Federal funding to per capita block grants. Using the numbers in the bill, it would reduce Federal spending on Medicaid by $350B between 2020 and 2027.

          1. But their block grant formula is totally stupid. Learn why.

            Using the numbers in the bill, it would reduce Federal spending on Medicaid by $350B between 2020 and 2027.

            Who pays the block grants, Argentina?

            Do you know that states REFUSED such grants in the mid-80s? They’d get the responsibility but Congress controls the revenues. The same conservatives who say you have no legal right to Medicare and Social Security?

  16. Ok, two days. A bit late but reason.com finally came around.
    An unscored plan is better because it is Republican.

    1. I think this is even worse – a govt plan being better than no govt plan. Let that roll around in your head a bit. You read it on a site that professes to be libertarian. How long before the “some restrictions on guns are okay” pieces trickle out?

      1. Where are you getting that from?

        I find it interesting how this article was simultaneously taken as proof of Reason being in the tank for Republicans, and also big-government shills (setting aside the fact that the writer doesn’t work for Reason).

        1. The commentariat here is among the worst online. I participate in over a dozen, across the entire political spectrum.

  17. Hillary-care cost Dems the Congress in ’94. The Heritage plan drawn as a possible counter so intrigued Pubs that it was never brought to a floor vote. O-care is a cluster. And now we have this. I wonder if there is a conclusion to be drawn.

    1. Probably that health care is complex as fuck and it’s really hard to get right.

      1. Actually, except for the actual doctor treating the patient, it’s not complex at all.

        1. Actually, except for the actual doctor treating the patient, it’s not complex at all.

          Then why has the GOP been screwing up so badly … for decades?

          Remember when they threatened to shut down the federal government to defund Obamacare … with no alternative Even today, all they have is political posturing.

          Do you really not know that keeping guaranteed issue (which is popular) and repealing the mandate (repeal being popular) GUARANTEES higher premiums than Obamacare? Or might it be more complex than you’ve been told?

  18. I have a question about conservative/libertarian thought –

    What drives the fixation on “giving choice back to the states.” It seems to me that libertarians in particular shouldn’t really care where the regulation is coming from; interference in the market is bad. It’s unclear to me why decreasing the size and scope of the federal government is such a central topic among free market and right wingers. A state’s jurisdiction is smaller of course, but they can regulate just as hard as the Fed can. Why is it considered such a win when something is “kicked back to the states”?

    1. Well for one thing if some states decides NOT to regulate, then people who don’t like the regulation can vote with their feet and move to one of them.

      With the Feds, someone would have to move out of the country to escape.

      1. That is a point, but it feels like it’s a very weak one. A company might move their operation if regulations get too onerous, but I strongly suspect the only time a private individual would be spurned to action over regional regulations is if they’re extremely rich and are looking for special tax advantages. The vast majority of people bitch about the regulation(s) to their friends and continue on with their life.

        1. Quite a few people have been moving out of high tax and high regulation states to low tax states for a long time.

          Plenty of people are moving out of New York and California every year.

          1. And Illinois and out of welfare cities like Detroit and Baltimore and Newark.

    2. It’s unclear to me why decreasing the size and scope of the federal government is such a central topic among free market and right wingers.

      Many confuse Federalism with the States Rights of the KKK. Ron Paul aming the very worst abusers.

      Led by Paul’s lies about the 9th Amendment, they claim states are not limited by the Constitution. They deny balance of powers, THREE co-equal branches and the entire concept of unalienable rights.

      Compare with Little Rock Arkansas in 1957. Governor Faubus activated his state militia ? brute force to keep 9 black kids from enrolling t Central High. Eisenhower sent federal troops, authorized to use force against a state militia — to defend the constitutional rights of 9 kids.

      Faubus folded, later “justifying” his action as defending the voters of Arkansas from an intrusive and overreaching central government. Sound familiar? Ron Paul does it constantly.

      He alaims “rogue judges” overturned DOMA — as he defies the 9th Amendment (which he lies about). Most shameful, he brags of co-sponsoring a bill to forbid SCOTUS from even hearing any challenges to DOMA — the first denial of a constitutional defense since emancipation.

      Just like the KKK, he gets pissed when the federal constitution denies his bigotry. Claims states rights. But only people have rights. Duh.

      That’s overall. Here, it’s legitimate to claim federal has no power, plus practical arguments.

  19. RE: The GOP Repeal Plan Sucks. But Is it Better Than Nothing?
    Not necessarily.

    Here’s an idea.
    Eliminate Obamacare and deregulate the healthcare industry (among others) so the market (and competition) can bring down prices and increase medical services.
    Oh wait.
    That makes sense.
    My bad.

    1. Shouldn’t you wait till the coal mines are reopened after their deregulation? That’ll ensure that the demand is high enough.

    2. That makes sense.

      Unless you get into detail.

  20. It’s also worth pointing out that no federal entitlement program has ever been repealed or replaced, or really even weakened.

    OK, but how many of them are there? This is like saying no major auto manufacturer has gone completely out of biz.

    A stronger bit of evidence would be that the USA is an extreme rarity among countries in not having socialized medicine. Really, it’s a wonder we made it this far given the strong worldwide tide of opinion.

  21. But obamacare broke the old system, which cannot be rebuilt. People did the right thing, paid for insurance while young, developed conditions, and now are uninsurable under the pre-obamacare rules.

    1. It was already broken ,,, since FDR created it.

  22. What Democrats understand but Republicans often don’t is that you can reach your goals incrementally.

    Apparently you don’t understand it either.

    The Republican strategy is explicitly *incremental*.

    Step 1
    Lacking 60 Senate votes, make the changes you can through reconciliation.
    Step 2
    With those changes in place, make changes on the regulatory end.
    Step 3
    With a NonObamacare baseline in place, try to go back to the Senate for votes for an improved alternative.

    The Repubs are actually playing to win, instead of making a statement. Take the ground you can first. Then see if you can pick off Dem votes for a comprehensive solution.

    1. Yes, better.

    2. You got the steps right. But the tactic is fucking stupid, since they have no hope of achieving step 3.
      They got trapped with campaign promises that were never possible ,,, and now they’re kicking the can down the road,

      When they get to Step 3, they’ll have a useless plan, as you admit, thus at the mercy of Democrats,

  23. You can’t repeal Santa Claus. Next time, stop the Man in Red at the top of the chimney before he hands out cheap gifts.

  24. Something better? You mean like repeal Obozocare immediately and completely and replace it with nothing?

    1. Something better? You mean like repeal Obozocare immediately and completely and replace it with nothing?

      They’re not stupid enough to try THAT again!
      Then again ….

  25. True enough. FedGov have NO place to be messing about with health care, insurance of any kind, or any market whatever. NOT assigned them in the Constitution, thus prohibited to it.

    but then, who of those who have sworn that oath to uphold, protect, defend, that “document” have ever even read it? Perhaps Ron Paul and his Son Rand… and MAYBE one or two of the recently seated folk.

    What these clowns fail to remember is the definition of FASCISM: defined, it is “government control of private means of proiduction”. Medical care is privatey owned as a means of production. But the degree of government control in it has gone far past the point of being fascism.
    Get FedGov OUTT, now. Full repeal. no replacement. Remove ALL the fetters on the market place.

    1. but then, who …. have ever even read it?

      Obviously, not you.

      Perhaps Ron Paul and his Son Rand..

      Fucking bigots deny the 9th Amendment, delegated powers, co-equal branches … and the will of the people.

      9th Amendment.

      The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

      Translation: Fuck you, Ron Paul, who says states have all powers not enumerated in the Constitution. That’s the Klan version of states rights, NOT federalism.

      Ron says “rogue” judges overturned DOMA. Oh? SCOTUS has no power to defend equal rights? We’re defenseless?

      Ron BRAGS that his bill would have forbidden SCOTUS to hear ANY constitutional challenge to DOMA. He would deny faggots (sarc) the right to … defend their rights! Not since slavery.

      Get FedGov OUT, now. Full repeal. no replacement.

      1) Can a President and both Houses of Congress be elected on that?
      2) You would defy “the will of the people?” I’ll kill you myself.

      The Constitution had NO power until THE PEOPLE ratified it. And EVERY action of the federal government is performed by agents elected by ? THE PEOPLE. THAT is what the founders intended.

      PHONY libertarians defend MINORITY rule ,,,, when they sneer at seeking election. WHAT THE FUCK DOES THAT LEAVE? Do they have enough guns for 3% to control America? Retards.

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