Rand Paul Thinks the GOP's New Health Care Bill Is Worse Than Obamacare

New Senate legislation moves the Republican bill in the direction of Obamacare.

Gage Skidmore / Foter

Senate Republican leadership released a revised health care bill this morning, and Sen. Rand Paul (R-Kentucky) is not a fan.

Asked today by The Hill's Rachel Roubein whether the new legislation is "worse than Obamacare," Paul said "yes."

"Do you think this is worse than ObamaCare?"

Sen Paul: "yes"

— Rachel Roubein (@rachel_roubein) July 13, 2017

Paul has opposed every iteration of the GOP's health care legislation on the grounds that none of them have gone far enough toward repealing Obamacare. Instead, Paul has argued that the Republican health care plans leave Obamacare's essential structure in place while bailing out insurance companies.

The health care legislation represents a significant overhaul from the version released last month. And in some ways it looks even more like Obamacare than previous iterations.

The new draft keeps some of Obamacare's taxes on high earners in place, and adds an additional $70 billion in funds intended to help states stabilize insurance markets, much of which would probably end up going to insurance companies.

The bill does include a concession to more conservative lawmakers, who have been pressing GOP leadership to include a provision that would allow insurers to sell plans that don't comply with all of Obamacare's regulations, provided they also sold regulated plans.

A variant of that provision, which was initially backed by Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah), is included in the bill, but it's not exactly the same as the one favored by Cruz and Lee. Lee, who recently told Reason's Matt Welch that the Cruz-Lee amendment was a must in order to get his vote, has indicated that so far he is undecided about the new legislation.

Just FYI - The Cruz-Lee Amendment has not been added to BCRA. Something based on it has, but I have not seen it or agreed to it. 1/2

— Mike Lee (@SenMikeLee) July 13, 2017

I am withholding judgment and look forward to reading it. 2/2

— Mike Lee (@SenMikeLee) July 13, 2017

Paul, on the other hand, is clearly a hard no on the current draft. He is joined in opposition by Sen. Susan Collins, a moderate Republican from Maine. Collins indicated on Twitter today that she will not vote yes on a motion to proceed with the bill. The bill must garner at least 50 votes on a motion to proceed in order to proceed to debate, and there are only 52 Republicans in the Senate.

The opposition from Paul and Collins, in other words, means that every single other Republican senator must support the bill—otherwise it will be dead before it hits the floor. With Lee and a handful of other GOP senators still undecided (and seemingly rather ambivalent about the merits of the legislation), it's going to be very close. And in the end, it could be two of the GOP's most staunch opponents of Obamacare, Paul and Lee, who cast crucial votes to kill the bill that Republican leadership has billed as Obamacare repeal.

Comments

[Longtobefree]

Repeal is a word with a specific meaning.
Republicans ran on a promise to repeal and replace Obamacare.
They have not, and do not intend to repeal Obamacare.
For whatever reason, they are determined to take full ownership of the fascist takeover of 18% of the US economy.
Unbelievable.

[BYODB]

They absolutely, and unequivocally did NOT run on repeal and replace. That second word, replace, didn't show up until it started to look like they might actually have a shot at repeal, which tells you how serious they were that time they passed a bill repealing the ACA, knowing it would be vetoed by Obama.

[Juice]

That's the thing. They secretly like Obamacare.

[BSL1]

It's not a very well kept secret.

[Mickey Rat]

There are enough of them that do like it or are afraid of the backlash in public opinion to block the rest if them from passing a repeal. That does not mean "they" like it in general. But that is the reason crap like the ACA needs to killed before it becomes law.

[ThomasD]

It's not just a backlash in public opinion, it's also big business that is quite happy to go along with the march to single payer. One less thing on their plate.

[Calidissident]

I definitely remember hearing "repeal and replace" for a while now.

[BYODB]

'for a while now' is how long one could describe Trump as being President, but during the Republican primary most of the candidates were still talking about 'repeal, full stop'. Well, besides Trump that is.

[Calidissident]

Well Trump is the one who got elected. And I wasn't even talking about just the presidential election. I seem to recall Boehner mentioning it in prior campaigns. Of course they voted for repeal knowing Obama would veto it, but I'm pretty sure they promised to "replace" it once they were in power.

[BYODB]

Correct when it comes to Trump, but just because Trump managed to get elected doesn't change the past.

[BYODB]

It could be that Boehner ran with some version of repeal and replace, I can't say positively either way, but it wouldn't surprise me since Boehner is exactly the kind of guy that makes the Republican party difficult to differentiate from the Democrat party.

Either way the majority of the Republican party was running on 'repeal, full stop' until it started to look like maybe they would need to actually do what they said. Then came the 'replace' talk.

[jonnysage]

Well voters thought Presidents make laws, and now they're getting a lesson in how ineffective they are without Congress.

[fdog50]

I recall that Republicans always talked about repeal, but Trump is the one who began pushing the "repeal and replace" stuff and naturally saying that what replaced it would be "beautiful". I wish he would stop using that word.

[Tony]

They would like to make good on the promise but they can't get the moderates to agree to the same things as the teabaggers. And, importantly, they don't actually have a policy proposal consistent with their ideological principles that won't end up shitting on millions of Americans. That's what they get for insisting that healthcare should be a privilege of the wealthy (unless you're geriatric and vote Republican, then it's a right).

[Unicorn Abattoir]

Health care is a right. And like other rights, it doesn't confer an obligation on another.

[Tony]

All rights confer obligations on others, even if it's simply "don't violate someone else's right."

What you mean is money. Which is silly, since the quasi-market-based status quo is the most expensive system in the world. So you don't actually mean money. You mean taxes. You'd rather be poorer and maintain an anti-tax dogma than be wealthier and concede that healthcare has to be socialized to be efficient. Whatever floats your boat, but that does mean, I hasten to point out, that you are the one thus imposing extra costs on me.

[Unicorn Abattoir]

Wrong. I have a right to free speech. You do not have an obligation to listen.

I have a right to own a gun. I don't have the right to make you buy me a pearl handled derringer, as I'm not a pimp in a New Orleans whorehouse.

Also, "efficient" and "effective" are 2 separate things. And I don't see too many "efficient" social programs.

[Tony]

Fine, other systems are both more efficient (cheaper per capita) and more effective (better healthcare outcomes). It's jus' data.

And your right to free speech obligates government agents not to interfere with it and obligates employees of courts to hear your case if your right is infringed.

If the only rights that exist are ones that we have on deserted islands, then what the fuck is the point of even talking about them?

[BYODB]

Tony, do yourself a favor and read up on the notion of positive vs. negative rights. Dumbass.

[Cynical Asshole]

I can't tell you how many times I've watched people attempt to explain the concept to his dumb ass on these threads over the years. You'd have better luck explaining quantum physics to a chimp.

[Tony]

I've done plenty of reading on the subject and conclude that there's no meaningful difference. It's a bit of rhetorical film-flam whose purpose is to provide you with a way not to make an argument for your policy positions on their merits, i.e., how they affect real human beings. All rights require government to confer them and secure them. Curiously you also don't seem to want to have a conversation about why we can only have so-called negative rights.

[BYODB]

If you've done 'plenty of reading on the subject and conclude that there's no meaningful difference' than you didn't do plenty of reading on the subject, or in fact any. They are entirely different concepts so I'll just go ahead and chalk this up to your room temperature I.Q. and unjustified narcissism.

[HazelMeade]

Is there a difference between murder and not rescuing?

[MarkLastname]

So, by failing to donate your last paycheck to UNICEF to save half a dozen starving children, you're guilty of multiple counts of murder? I suppose the failure to see the distinction may explain why leftists condone murder en masse of people they disagree with or fail to comply with their edicts: those kulaks are literally killing people by preventing the Utopia from forming.

It's also pretty clear that you're not well read at all, but rather just drop names and terms you picked up from 'Philosophy for Idiots.'

[jerbigge]

The complete deregulation of health care would bring down costs to something comparable with the rest of the developed world. No prescription laws, no laws against private import of medical drugs, repeal of the drug laws period. Certification in place of licensing. On line consultation with medical providers outside the US. The enhancement of medical tourism.

Our problem is due to the creation of a health care system where "profit" comes before anything else. The drug companies have no interest in anything that they can't patent and copyright. There is a book "Rigged" that goes into detail on this. I downloaded a version for my Kindle for $1.99.

[frankania]

You are right, jerbigge! Get govt OUT of healthcare, and let the free-market rule. That is what we have here in Mexico...many many private doctors, clinics, labs, pharmacies, etc. most of which require NO prescriptions for medicines nor tests. The IMSS govt. run healthcare is slow and bureaucratic and very cheap--less than a dollar a day for most coverage. But, most do NOT have insurance at all.

In the USA, folks could just buy HIGH deductible policies for serious illness, and pay CASH for day-to-day healthcare.
Of course there will be govt. and CHARITY clinics for the poor. Big brother, leave me alone!

[mortiscrum]

You want to remove government from healthcare entirely, which would unleash the power of the market, because right now the system is only based on profit...? I hate to burst your bubble, but the whole point of "free markets" is to allow capitalistic profit-seeking meet the needs of people in the most organic, efficient way. Deregulation does not remove a profit motive from the system, it embraces it with both arms.

[GroundTruth]

And your right to free speech obligates government agents not to interfere with it and obligates employees of courts to hear your case if your right is infringed.

This is a great example of the difference between positive and negative rights. A positive right, such as health care, ALWAYS costs somebody something, but a negative right, like free speech, costs nothing unless it is violated.

The Bill of Rights contains only negative rights, costing the taxpayer nothing, until they are violated. Even the right to a jury trial (which costs the juror time, and the taxpayer the court's salary etc.) begins with the accusation of the commission of a crime.... i.e., it is NOT a normal state of affairs, but rather something that has to be repaired.

[Cynical Asshole]

healthcare has to be socialized to be efficient.

https://www.youtube.com/watch?v=LQCU36pkH7c

[jerbigge]

No, it doesn't. However when organizations can get the government to provide them with a legal monopoly, then health care gets real expensive. The AMA has worked since its creation in the 19th Century to restrict the supply of doctors, make their education more expensive to justify much higher fees being charged to everyone else. Other countries, smarter than us, didn't do this sort of stuff.

Professional organizations are simply labor unions that have organized to get more money for their profession at the expense of everyone else. No real difference between the AMA and the UAW. The AMA makes health care more expensive. The UAW used to make cars more expensive until foreign competition forced prices down.

[HazelMeade]

concede that healthcare has to be socialized to be efficient.

Unlike everything else in the world, which gets less efficient when socialized.

[notJoe]

"Teabagger": Fuck you you commie douchebag.

"...insisting that healthcare is a privilege of the wealthy": A) WTF is "healthcare"? B) CITE PLEASE.

[Tony]

noun. the maintenance and improvement of physical and mental health, especially through the provision of medical services. Source: Google dictionary.

[notJoe]

For once in the entire time you've posted here, BACK UP YOUR STATEMENT. Who insisted "healthcare is a privilege of the wealthy". When did they say that? Why did you connect them with "Republicans" in general?

In other words, CITE PLEASE.

[Tony]

Well they're not going to say it, they're politicians. But describe for me how it's not the upshot of a totally market-based approach to healthcare. What happens if you can't afford healthcare?

[Unicorn Abattoir]

What if you can afford it but it takes 6 months to see a doctor?

[Tony]

The unstated assumption in this scare-tactic canard that's trotted out to distract from the fact that every other system is empirically better than ours is that we don't have long waiting lines now because so many sick and poor people are left without care, leaving the queue nice and short for you. Right?

[HazelMeade]

You seem to be operating under the illusion that what we have had is a free market. But in reality, it's been heavily regulated and full of government interventions since the 1930s.
Most people are on tax-subsidized employer based plans or Medicare/medicaid.
The tiny segment of the market that provided private individual plans was tightly regulated.

You're just bitching that the free market doesn't force people to provide what you imagine is a positive duty to pay for other people's health care. That's not a market failure. A market failure is not "waa, the market didn't give people free shit, and make other people pay for the free shit!" The market is ruthlessly fair in the way it provides a quid quo pro of value for value, and it does so very efficiently when left alone. Nobody gets anything for free. It doesn't instantiate values like "people have a right to health care" or "people should pay for other people's health care". You want poor people to have healthcare, give them money.

[mortiscrum]

RE: You seem to be operating under the illusion that what we have had is a free market. But in reality, it's been heavily regulated and full of government interventions since the 1930s.

If the United States hasn't had a free(ish) market for healthcare since before the 1930's, what makes you so sure it'll work? Where in the entire world is there an example of free markets working well to deliver modern medical care? The rise of insurance companies and government interventions in the market didn't happen for no reason; it was all to address a need: healthcare was too damn expensive.

[HazelMeade]

Where in the entire world is there an example of free markets working well to deliver modern medical care?

medical tourism markets.

[mortiscrum]

RE: medical tourism markets

So, looking only at the people who have the means and information to travel the world and seek out exactly the care they want is evidence that free markets are capable of delivering care to a diverse and economically stratified population? That's patently absurd. The measure of a healthcare market cannot be "does it serve the richest 15% well." The other 85% of the population gets sick too.

[HazelMeade]

you get treated, and then you go bankrupt. And you're a dumbass for not at least having a minimal health insurance plan that protects you from bankrupcy. I.e. catestrophic coverage.

[MarkLastname]

No way we can have that! Nothing is more anathema to a progressive than the possibility that somewhere, someone may actually have to endure the consequences of their own choices.

[notJoe]

Well they're not going to say it, they're politicians.

So nobody insisted that. You made it up. As usual.

But describe for me how it's not the upshot of a totally market-based approach to healthcare.

Please point to one Republican politician insisting on a "totally market-based approach" (by which I take it you mean you cannot see a doctor if you're sick and have no money). Looks like you're making up ridiculous straw men, but if you're serious, CITE PLEASE.

[mkreitler]

Singapore has (arguably) the most efficient health care system in the world:

http://healthmatters4.blogspot.....ealth.html

While it's true that the government requires citizens to sock money away into HSAs, the hospitals themselves compete on price. It is as close to a free market health care system as you will find.

That isn't to say that government has no place in such a system, but that place should be to foster competition and mediate disputes, not providing services (unless you want VA-quality care).

[mortiscrum]

RE: Singapore has (arguably) the most efficient health care system in the world

Singapore's healthcare is really cool, but it is NOT free market. Not even close. Along with the legal requirements to fund an HSA, the state owns something like 90% of the hospital beds in the country. The state also dictates treatment and drug prices, and the money spent from the HSA can only go towards government-approved treatments.

In other words, it has about 10 different things going on that would get any politician laughed out of office in the United States.

[mad.casual]

"Teabagger": Fuck you you commie douchebag.

That would make Tony the teabaggee (NTTAWWT), no? Libertarians would be the guy who walks in with his head down, sees what's going on and says, "OH! Sorry." and backs out quietly with his hand over his eyes.

[jerbigge]

They don't believe in a free market in health care either. I like Rand Paul's plan, and think it is better than the House plan. Paul's plan also gives people to select the level of insurance they want, it allows for the organization of health plan purchasing groups which neither the House plan or Obamacare allow. And while Paul isn't libertarian enough to want to repeal the Roosevelt era prescription laws (one of the driving forces of our overpriced health care), it is at least a step forward to something "better".

[Robert]

I'm sure he's libertarian enough to want it.

[tlapp]

If you remember the howls from democrats over the Bush era Patriot Act as the horrible attack on civil liberties. Then the democrats renewed the entire law as is when they controlled all 3 branches of government.
Now the republican establishment backing only minor tweaks to Obamacare. That is our one party system, the party of growing government power and control.

[BYODB]

I truly wish this man had become President, and I wish him the best of luck in his next attempt should there be one.

[Crusty Juggler - Double Great]

Whichever one of his advisor(s) that convinced him to run hard to the socon side should be publicly flogged, or at least be made to strip down and dance on stage at the next Libertarian Party convention.

[BYODB]

Rand isn't perfect in a lot of ways, but I at least think he's principled and that means a whole hell of a lot more to me these days than 'does he perfectly mirror my vision of what a candidate should be'.

I'll support him every time he runs, provided something major doesn't change.

[jelabarre]

...or at least be made to strip down and dance on stage at the next Libertarian Party convention.

Careful, depending on who it is there might not be enough brain bleach to recover from that one. It could be Janet Reno's uglier sibling.

[Crusty Juggler - Double Great]

The new draft keeps some of Obamacare's taxes on high earners in place, and adds an additional $70 billion in funds intended to help states stabilize insurance markets, much of which would probably end up going to insurance companies.

Conservative principles!!

[Juice]

The bill does include a concession to more conservative lawmakers, who have been pressing GOP leadership to include a provision that would allow insurers to sell plans that don't comply with all of Obamacare's regulations, provided they also sold regulated plans.

Why would it matter if they also sold "regulated plans"? Why is that a requirement to allow insurance companies to sell other plans (which would also be regulated)?

[Calidissident]

In theory, it's supposed to allow insurance companies to sell plans that don't meet Obamacare's mandates, while also allowing consumers the option to purchase plans that are compliant with the ACA (benefit mandates, guaranteed issue, community rating, etc.).

[Bob K]

So startup companies can't get into the market, only large and established ones can sell you things. This is a Republican bill after all. They can't allow the free market to get in the way of crony capitalism.

[MarkLastname]

Good point. Eliminating barriers to entry should a top priority for, well, for every industry.

[Cynical Asshole]

They're probably worried that if they allow insurers to sell non-ACA compliant plans without also offering ACA compliant plans on the exchanges, then every insurer would cease to offer plans on the exchanges.

[SQRLSY One]

Ha! If I was an insurer, with 12 billion mandates (covering EVERYTHING, just about, as being "medically necessary") under existing Obamacare, I would "ACA-comply" by offering the platinum-and-unobtanium-plated plan... At a cost of 7 million dollars a year!!! Now EVERYONE can be a 7-million-dollar man!!!

[BYODB]

This is why they're talking about linking the two so that if you increase the price of the ACA plan, you're obligated to raise the price of the non-ACA plan by the same amount. Seriously.

[MarkLastname]

Half measures.

[Mencken Sense]

Better to pass nothing and let Obamacare burn.

[Tony]

Why?

[Get To Da Chippah]

So it can be an object lesson on what happens when Democrats get to pass laws when they have control of all the levers of power.

[Tony]

Who controls said levers now?

[MarkLastname]

To educate the electorate on the negative impact of price controls and rationing on cost, quantity, and quality of healthcare, so they (hopefully) vote the morons who did everything to save it out of office.

[Tony]

The electorate, being dumb as we both agree, will probably just blame the Republicans in charge for their incompetence.

[MarkLastname]

You're likely right. They will likely double down on Democratic stupidity because of the Republicans stupid failure to undo the previous round of Democratic stupidity. Basically how Chavez and Tsipras types come to power. Think Bernie will live another 3 years?

[Stormy Dragon]

Yeah! I mean look how popular Nero is!

[MarkLastname]

That's mean if you to compare Obama to Nero. He wasn't that bad.

[Uncle Jay]

RE: Rand Paul Thinks the GOP's New Health Care Bill Is Worse Than Obamacare
New Senate legislation moves the Republican bill in the direction of Obamacare.

Rand is correct.
This is nothing more than the republican version of OBamacare.
What's the difference between republicans and democrats again?

[Cynical Asshole]

One party sucks and the other one blows?

[SQRLSY One]

One party got stupid mixed into their evil,
and the other party got evil mixed into their stupid?

[mkreitler]

> One party got stupid mixed into their evil,
> and the other party got evil mixed into their stupid?

How can something be so funny and so true at the same time???

[SQRLSY One]

Wait! Am I allowed multiple guesses?!?!

One is the party of lying panderers, and the other
... is the party of the pandering liars!

[Headache]

^This^

[Magnitogorsk]

Why can't they at least get rid of the regulations about what plans have to provide? I understand other parts are harder to repeal because people have already gotten the hand-outs and don't want to give them back. Axing the regulations seems like it should be the easiest part.

[Ken Shultz]

If Rand Paul is the only thing standing between us, on the one hand, and cutting Medicaid eligibility, getting rid of the individual mandate, and getting rid of the 29 hour work week/employer mandate, on the other, then a) he will have no hope of winning the Republican primary for the presidential nomination any time over the next eight years, and b) this libertarian is going to give money to whomever runs against him and voted for the plan.

If Rand Paul votes against cutting Medicaid eligibility, then fuck Rand Paul.

[Robert]

I agree. Those measures are huge. I think he's miscalculated if he thinks he can bargain for something better by rule-or-ruin.

[BYODB]

See, that's how you reframe an argument into something that is notionally true but mostly blown smoke.

Good job Ken.

[HazelMeade]

I'm not sure that a market with more regulation but less welfare is really the direction we should be going in.
The whole deal you have with medicaid seems to me like you're saying your totally okay with a government takeover of the entire insurance market as long as there's less direct aid to the poor. It's kind of ... corporatist. You'd rather have a highly regulated marketplace where the government controls everything in a corrupt public-private partnership, than a free market with a minimal welfare state.

[MarkLastname]

Does this constitute 'more regulation?' By letting insurers engage in some level of price discrimination the regulatory burden would be slightly less than before, with a freer pricing range and broader range of services, and a little more competition.

I agree though that freer markets with welfare is better than more regulated markets with less welfare. If the 'welfare' is coupled to the price of healthcare, then a freer market should drive down costs and thereby help cut the cost of subsidizing the poor as well.

[mopoos]

The individual markets will fail. Guaranteed issue on demand is absolutely unsustainable but they aren't willing to axe it. If the Republicans touch this they will be blamed for everything and they will be destroyed, loosing much more than the battle on healthcare in the process. Rand and Snow are saving them from themselves.

[Ken Shultz]

The AHCA effectively cuts Medicaid eligibility and gives those people subsidies to go out and buy their own health insurance. If this senate plan still does the same thing--and gets rid of the individual mandate--then it should be supported by libertarians everywhere.

Moving people from Medicaid to private insurance with subsidies is exactly like moving kids from public schools to private schools with vouchers--and doing both should be supported by libertarians everywhere for all the same reasons. Indeed, moving people from Medicaid to private insurance through subsidies isn't just a way to replace ObamaCare; it's ultimately the road to getting rid of Medicaid entirely.

[Tony]

Does it not bother you that all the evidence with respect to charter schools have demonstrated the experiment to be a total failure?

Party < dogma < .......... < empirical facts = Ken

[Ken Shultz]

Do you have a link to this evidence, or are you just making shit up again?

[Tony]

A fair enough breakdown of the research.

[Calidissident]

You realize that doesn't really back up your argument? At best, you can the evidence is mixed. Most of the studies I've seen indicate that charters are beneficial or at least no worse than traditional public schools.

Also, countries like Sweden have educational voucher programs, is their public education system nonexistent? I find it funny a Clintonista like yourself uses "neoliberal" as a slur/bogeyman so much when I seen the Clintons (and Obama) referred to as such all the time by both critics (e.g. Bernie fans) and supporters.

[BYODB]

Like most things, Tony doesn't understand liberalism. Lord knows there aren't enough classical liberals left, and Tony definitely doesn't fit into that box.

[MarkLastname]

The consensus of the quantitative research thus far seems to be that charter schools perform about the same, maybe slightly better, but not significantly, at a lower cost. A voucher system would mainly serve to cut costs while keeping quality the same.

Tony is just shitting in the rug. He wouldn't know a regression if one crawled up his ass. The fact is, what school you go to isn't a major independent predictor of success; in fact it may be close to negligible. Parenting, innate IQ, and community stability are what determine outcomes; it just so happens that good, innately intelligent parents prefer to live in good safe neighborhoods which also have 'good' schools. But most of the money spent on public education is wasted.

These facts aren't popular, of course; most people want to believe the kids would all be brilliant if just shelled out few hundred more per student for the latest textbook edition. Really though the value of charters is that they drive down costs without undercutting quality; because there's basically nothing any school can do to make kids (or their parents) not natural morons, etc. in reality, if you pick poor kids with poor parents by lottery and put them in the best schools, the net improvements they show on average are almost nonexistent. But that reality doesn't feel good, hence Tony.

[Ken Shultz]

Are you citing outcomes based on quantitative criteria that couldn't possibly reflect the qualitative preferences of parents? Who are you to say that parents made the wrong choices for their children--when you don't even know the qualitative criteria those individuals are using?

Maybe one school feels safer than another. Maybe one school has fewer gang and drug problems. Maybe one school has ice skating or a ballet class. Who are you to judge the relative desirability of other people's qualitative preferences?

If you really think you know what's best for other people, then you might as well be on the religious right--because fundamentally you're just like them.

[Tony]

And let's be clear, we're both talking about taxpayer-subsidized education, and since I'm not a dogmatist, I don't particularly care what we call schools that are publicly funded (though public schools seems straightforward enough). You should have to prove the case that education can be delivered on the same scale and quality without any vouchers, or argue that education should be available only to those who can afford it. Otherwise don't the "socialists" win the argument?

Of course voucherization is a stepping stone to full-on neoliberal gutting of public education (complete with rampant corruption as these things always are). But that's neither here nor there.

[HazelMeade]

There is significant evidence that public schools improve when faced with competition. So if you're just looking at statistics that say "charter schools aren't better than public schools", or "voucher students don't do better than public school peers", you may be missing the fact that both sets of test scores improved because competition drove the public schools to improve their performance.

[ChipToBeSquare]

Lately the left really loves decrying "neoliberalism". Really interesting to see the works of Walter Lippmann have been making such a comeback

[Ken Shultz]

"And let's be clear, we're both talking about taxpayer-subsidized education, and since I'm not a dogmatist, I don't particularly care what we call schools that are publicly funded"

Tony wants to turn it all into a word game that it isn't.

There's a fundamental difference between bureaucrats forcing you to go to one school and being free to choose whatever school you think is best for your children.

No one can make qualitative choices on other individuals' behalf with anything like accuracy.

It's even worse with healthcare. Being forced into Medicaid is not fundamentally the same as being free to choose whatever plan you want--certainly not just because they're both paid for by the government.

Each individual has a unique blend of qualitative preferences which neither you nor anyone can ever fully account for. One of the best things about markets is that they let individuals choose according to their own personal qualitative preferences--like no other system can allow.

[Johnny B]

Hey, Tony -- Maybe you should go read Marginal Revolution: Here is a sample of recent stories on school vouchers:

http://marginalrevolution.com/?s=school+vouchers

[ChipToBeSquare]

I'd add Scott Alexander's piece there. He usually tries really hard to be a leftist but he often comes down as some sort of left-libertarian once he delves into the evidence

http://slatestarcodex.com/2016.....schooling/

[MarkLastname]

I think it's pretty obvious at this point that Tony actively avoids reading about research that might contradict his worldview. He will dismiss it out of hand, maybe because Tyler Cowan is partly funded by the Koch brothers or some bullshit.

[John B. Egan]

Both Ron and Rand Paul hypocritically want US medicine to be a free market operation, with no Obamacare, no Trumpcare, no government programs like Medicaid or Medicare, yet both seem to have been quite willing to service Medicare and Medicaid customers to fatten up their bank accounts. Whatever would Ayn Rand say? OMG! How do they even look at themselves in the mirror each morning?

[BYODB]

Anyone who utters the phrase 'service Medicare and Medicaid customers to fatten up their bank accounts' is borderline retarded. They often times cost the provider money to see them, as in each of their visits is a net loss for the provider. This is especially true in their particular type of practice, if memory serves.

Perhaps my sarcas-o-meter is broken though.

[ChipToBeSquare]

Republicans are just Democrats driving the speed limit

[HazelMeade]

There's a couple of provisions I really like:
1. Allows the sale of catastrophic coverage - this is key to restoring something resembling a free market. if that undermines the plans on the exchanges designed to force the low risk to subsidize the high risk... feature, not bug.

2. Allows people to use their HSAs to pay premiums. This is an admirably clever and sneaky way to make individual plans tax deductible, which helps nullify the tax advantage given to employer-based plans. Bravo.

[Free Oregon]

Government cannot solve the healthcare funding issue until We the People change the way we grow our food, increase its nutritional content, eliminate pollution, and move to a more sustainable lifestyle. In theory we can take the required actions voluntarily at relatively low cost. In practice we face so many people who vested interests in the status quo that we will wait until the present system collapses. Only when forced to act, will we open our eyes to alternatives.

All this talk about funding obscures the fact that Medicare, Medicaid and now Obamacare are subsidies for a sclerotic healthcare system that delivers poor quality at exorbitant prices. Remember the hospitals that were going bankrupt right and left in the 1970's? Now, not so much.

[flyfishnevada]

So, eat well, recycle and let the ACA fail. Solid plan you got there.

[Uncle Jay]

RE:
Rand Paul Thinks the GOP's New Health Care Bill Is Worse Than Obamacare
New Senate legislation moves the Republican bill in the direction of Obamacare.

Its called "Republican care."
Its a form of Obamacare only made by republicans.
Now its the republicans turn to create socialized medicine for the masses.

[Hank Phillips]

You'd thing young Randal would have little spare time for pursuits other than licking the blacking off of Beauregard Sessions' boots.

[flyfishnevada]

Gutless wonders! Given control of Congress and the Presidency, along with the gift Dirty Harry left them in the form of the budget reconciliation tactics used to pass the ACA in the first place, they can't even repeal the damn law, much less come up with a replacement (which is the last thing we need). The Dems didn't balk when the had a filibuster proof majority. They wrote a bill, flew the bird at the American public, made up some rules when things didn't quite work out and passed it. As much as I dislike the Dems, I respect their chutzpah. I can't say the same of the GOP...well, except for the dislike part. I don't like or respect them as a group.

And for Cruz and Lee's part, they're willing to vote for this debacle if leadership throws them a bone? The GOP: Go along to get along.

[AD-RtR/OS!]

As usual, Rand demonstrating his NIH Syndrome status.

[John40]

These elected gangsters do not want to give up their power and control.

[pifufewu]

??????Otil I saw the receipt that said $6460 , I did not believe ...that...my mother in law wiz like they say actually earning money in their spare time from their computer. . there aunt started doing this for under thirteen months and recently clears the adepts on there mini mansion and blurt a great Aston Martin DBL . go to this website.....??????? ?????____BIG.....EARN....MONEY___???????-

[http://appnaz.com]

TRUMP is extremely annoying!

[AmberChelsea]

Obamacare is more suitable for people with lower income than Trumpcare.

[BYODB]

Have a citation that Ron Paul was an actual card-carrying member of the KKK? Or are you just making defamatory hyperbolic arguments based on a news letter?

[HazelMeade]

This is like reading something written by a bot designed to mimic a schizophrenic.

You have no idea what you're talking about. And you're incapable of expressing what you think you do coherently.

[Calidissident]

Hihn if you're gonna be snarky, you should at least understand what the other person is saying. HSAs are tax deductible, but you can't use HSA funds to pay premiums. This rule change would allow people to effectively buy non-group health insurance with pre-tax money, which you cannot do currently. I don't know what you mean by "not individual."

Of course, I haven't heard anything to indicate that they're removing the requirement of having a HDHP and if the contribution limits stay the same, that means less money to use tax-free to pay for other medical expenses. Nonetheless, I think it's an improvement.

[creech]

"2) If they HAVE a catastrophic illness -- like cancer .... WHERE DO THEY GET $5,000?????"
I actually asked my doctor this two years ago. His answer was that every oncologist he knew would gladly do the initial $5,000 on a pro bono basis because he'd know the patient's insurer was going to cover the next $1mm.

[Headache]

I think it is 15%, but that number may have changed since when I checked year back. Medicare pays less than Medicaid. And VA (Choice Program) even less.

This puts the burden on private insurers to make up the difference.

[BYODB]

Not to antagonize you, but your link doesn't work.

[BYODB]

I watched the video that you somehow managed to post correctly in one thread but not the other, and what he proposes sounds better than the other proposals I've heard so far. I'd prefer an actually free market, but do you think this is a step toward authoritarianism or a step away, honest question. It's actually pretty grounded in free market principles, by and large, and I didn't hear anything particularly anti market..

The link Hihn meant to post.

[BYODB]

And notably, you lied that 'repeal and replace' originated with Rand Paul. This video is from 2017 as far as I can tell.

[MarkLastname]

IOW, it's basically a way to extend the tax deduction currently provided to those who get insurance through employers? That'd be nice.

[mkreitler]

Michael, you may want to read up on the literary Laffer Curve: if you write less, people will read most of your posts.

[BYODB]

So, in other words, no you don't have any citation or proof that Ron Paul is or was a member of the KKK.

In other words, you're lying.

You like to smear your feces all over these boards making accusations of 'aggression' yet have no problem making things up yourself. If it wasn't for double standards, Hihn, you'd have none at all.

[mkreitler]

*sigh*

"...read *more* of your posts," not, "most of your posts."

[mortiscrum]

RE: since the 1500s health care

Healthcare prior to the 1900's was largely nonexistent. There's absolutely no parallels to draw between paying for the local "medicine woman" to give you some advice on how to get rid of your headache and treating diabetes or getting an MRI.

Free markets aren't about embracing profit seeking....? Not really sure what to say to that....

And just to clarify, I'm not libertarian - neoliberal is much more accurate. "Statist," if you will.

[HazelMeade]

Yes, so presumably the rule change will allow people to open an HSA, and THEN use it to pay for their health care premiums. You do realize what the word "change" means, right?

[Calidissident]

How bad is your reading comprehensions? You notice the part where you said "tax-deductible cash remaining after the premiums are paid for a high-deductible insurance?" The key word there is after. Under current law, you cannot use HSA contributions to pay premiums for a HDHP. The change being proposed would allow that. How is this hard to understand?

[HazelMeade]

Who the hell can't pay off $5,000 over a year or two?
The people complaining about the high deductibles are just moochers who want more free shit.

[HazelMeade]

Thank god, you have cancer. Hopefully, it won't be long before we never see your posts again.

[mortiscrum]

RE: Nobody said otherwise. You missed the point. Human nature.

Didn't YOU say otherwise, though? Your point seems to be that healthcare costs were covered adequately prior to insurance companies and government spending via charities, churches, etc. My point is the healthcare costs when charities were the primary provider/payer look absolutely nothing like modern (circa 1920's) healthcare costs.

RE: the MOST likely to die uninsured were ... Medicaid/CHIP eligibles

Lots of people who are eligible for Medicaid coverage don't sign up, it's true. Not entirely surprising though, considering the population Medicaid serves. Perhaps something could be done to make people more aware of the benefits available to them, but I don't see that particular problem as a criticism of the quality of coverage. People who have Medicaid report a high level of satisfaction, comparable to private insurance recipients.

[Calidissident]

*the extra s at the end of comprehension was a typo

[Calidissident]

Yes, with a couple of catches:

1) With no other rule changes, you can only use it to buy a plan with a high deductible, whereas this is not a requirement for group insurance.
2) You're limited to the annual contribution limit (unless you already have saved up years worth of premiums) to make tax-free payments. There's no limit for group insurance.

[Red Rocks Baiting n Inciting]

Punkin, the only thing you ever kicked the shit out of is your own sanity.

[Red Rocks Baiting n Inciting]

Snippy name-calling. Anything speciic would be jammed up her ass

Hihn-sano, the only thing you jam up anyone's ass is the fleshlight embedded in your own rectum.

[BYODB]

Well, I mean other than the video that you provided doesn't indicate most of what you say nothing in particular. I've never made the claim that Paul is perfect, or even close to it, but if you'll recall Trump was elected in November 2016 and was going off about repeal and replace for at least a few months prior to that. So laying the 'repeal and replace' at Rand's feet when it's pretty clearly being pushed by good ol' Mitch and Trump is disingenuous at best and ignores several months worth of history prior to January.

I would need to actually read what his plan was in January though, because the linked video doesn't provided any particular information beyond 'allowing' people who run their own business to pool themselves and, frankly, I'm not clear what he's talking about when they talk about the 2 year cut-off. My off-the-cuff assumption is that this is the time period they have to phase out the guaranteed issue portion, but perhaps not.

Your claim that, if not for Rand Paul, the Republican's would have repealed Obamacare without a replacement is obviously false though. No offense.

[mortiscrum]

RE: ENTIRELY NONPROFIT

Indeed; entirely nonprofit, and increasingly inadequate. I repeat: the current system, poor as it is, came from a need. Ergo, the system in place prior was not doing a good enough job. Simply rewinding the healthcare system to 1850 is both politically impossible and undesirable.

[Red Rocks Baiting n Inciting]

That was your dumbass assumption

He's a fascist, but not quite as bad as his KKK father.

Dumbfuck Hihn-sano.

[Red Rocks Baiting n Inciting]

Cry more, Hihn-tard.

[Red Rocks Baiting n Inciting]

Same on you, defending Ron Paul's KKK roots

Dumbfuck Hihnsano makin' up shit again LOL.

[Red Rocks Baiting n Inciting]

Dumbfuck Hihnsano spamming again.