Obamacare: Say goodnight, Gracie...

[Libertarian01]

Just a personal observation and I could be totally off on this but it seems to me that nurses are the most underutilized segment of the healthcare industry. They are highly trained and capable of so much, yet they are delegated to simple paperwork and maintenance of patients.

I met a man who did some missionary work in Papua, New Guinea. He explained that over there the nurses did what doctors do here, at least as far as general practitioners. The nurses would diagnose problems and prescribe medication. It was only when a nurse couldn't figure out what was wrong that you would see a true MD.

It seems that nurses are highly trained and yet we exploit only a tiny fraction of their skills that we are wasting so much potential.

Regards,

Doug

 

[Alpo]

Hence, the Nurse Practioner category.

 

[Vigilant]

Since this is the best place to ask, rather than start another thread, WHY all of the sudden, is Nancy Pelosi interested in reading a healthcare bill BEFORE it's voted on?

 

[Ericpwp]

I don't know, you have to pass it to know what's in it.

 

[actaeon277]

Since this is the best place to ask, rather than start another thread, WHY all of the sudden, is Nancy Pelosi interested in reading a healthcare bill BEFORE it's voted on?

And yet, everyone screaming about the R's forgets that she said that.

 

[zippy23]

The democrats are going to go through the GOP bill letter by letter. They will find anything they can lie about and scream about it and protest. This is how they operate. Its purely political. See, democrat voters just flat out dont care about what their politicians actually do. They will follow them blindly to their death. Republicans on the other hand, will eat their own just because a democrat publicly accuses them of racism or sexism. This is why trump is so hated by both parties. He'll throw it right back in their face publicly.....but back to the GOP plan....lets be honest, it does some things that obamacare does. It does get rid of the mandate. It will allow insurance across state lines. It will allow catastrophic plans again. Thats a lot better than what i expected from the republican establishment.....and the bill isnt even close to being finalized. Paul Ryan's tape was just leaked, perfect timing, and he's gotta play ball now with trump. If trump does what his PDF on his website says, then that'll be wonderful. We'll have to wait and see how this goes. Until then, lets not eat our own just because some wacko liberals scream about it everyday. They are going to scream about anything and everything the republicans do. Just sit back and KNOW that Clinton is not president, you dont have to worry one bit right now about your guns. The supreme court pick was great. Trumps looking like he'll seriously cut down on the executive branch, and his budget cuts gov't. THINK ABOUT THAT. He offers to actually "historically cut" govt agencies. We should all be praising this man every single second. We havent had this, at least not me, in our lifetimes.

 

[BugI02]

This is such a bloody mess. I am convinced that the ACA was designed to default to single payer when it inevitably failed, likely with a new tax ala medicare to (likely only partially) fund it. The only viable path I can see is full repeal now with a firm future date (1/20/2020 perhaps) and iron out the details of replace on the fly. No matter what, a lot of somebodies will not have a seat when the music stops because they won't use much of their own money to stay insured

 

[bwframe]

We have to come up with an immediate repeal plan that includes a HUGE amount of continual PR. It needs to be successfully explained to the semi-entitled crowd that Obama's plan was never intended to be successful, but default to socialist single payer.

 

[Ericpwp]

Unfortunately there are too many that think that is a great idea.

 

[jamil]

I'd really like to see the public all become aware of just how Obama/Pelosi/Reid shoved 0bamacare down the throats of America. The famous quote was just a small part of the parliamentary tricks used to do it.

 

[Twangbanger]

This is such a bloody mess. I am convinced that the ACA was designed to default to single payer when it inevitably failed, likely with a new tax ala medicare to (likely only partially) fund it. The only viable path I can see is full repeal now with a firm future date (1/20/2020 perhaps) and iron out the details of replace on the fly. No matter what, a lot of somebodies will not have a seat when the music stops because they won't use much of their own money to stay insured

Nah..."Single-Payer / Public Option / Medicare for All" effectively died when Teddy Kennedy died, Scott Brown took his place, and the Democrats couldn't get 60 to stop a filibuster on Obamacare. I think O-care has worked out exactly as intended: a really clever way for Insurance Companies to make money off insuring the Poor, at taxpayer expense. It's a Military-Industrial Complex, with Insurance companies acting as contractors to the government for the purpose of providing insurance plans. Only, instead of the taxpayers buying $600 hammers from Raytheon, we will be subsidizing exorbitant premiums to United/Aetna/Humana, and tacking the cost onto the debt.

The government's own study predicted last year that within 5 years, 39% of the exchanges will only have one Insurer left in them. That means a "monopoly," with more exchanges sure to follow. In fact, I wouldn't be surprised if the Insurance Companies decide which areas of the country they want to dominate, drop out of all the other exchanges, and focus all their resources on their "target" exchanges to drive out competitors. Once the desired monopolies develop, they will isolate the Congressmen & Senators from those states and lobby them to maintain those monopolies. There is money to be made in all this; it's just taking some time to shake out.

Most people will not care. After all, most people are not on the exchanges, and most Americans don't feel personally responsible for the National Debt. Liberals will feel happy the poor have "coverage," and we'll just tack the cost onto our borrowing. "We can find the money to fight wars; we will find the money to Cover the Poor."

And I believe Conservatives are powerless to stop this. The insurance companies knew what they were doing when they helped write this bill.

 

[jamil]

About the ACA, Harry Reid got around the Filibuster by taking an unrelated bill the house had passed unanimously, and as part of Senate reconciliation of that bill, he replaced the entire text of that bill with the text of what eventually passed as the ACA. Reconciliation cannot be filibustered. This is also why the house had to pass the reconciliation bill cleanly, or it would have to go back to the senate.

 

[jamil]

Oh. One other thing. Remember when Obama browbeat Justice Roberts, and said the ACA was passed by congress with bipartisan support? That's only technically true. Not one Republican ever voted for any bill with the text of Obamacare. The original House bill that had passed unanimously, was a bill for veterans. THAT's the bill Republicans supported.

****ing liars.

 

[BugI02]

Nah..."Single-Payer / Public Option / Medicare for All" effectively died when Teddy Kennedy died, Scott Brown took his place, and the Democrats couldn't get 60 to stop a filibuster on Obamacare. I think O-care has worked out exactly as intended: a really clever way for Insurance Companies to make money off insuring the Poor, at taxpayer expense. It's a Military-Industrial Complex, with Insurance companies acting as contractors to the government for the purpose of providing insurance plans. Only, instead of the taxpayers buying $600 hammers from Raytheon, we will be subsidizing exorbitant premiums to United/Aetna/Humana, and tacking the cost onto the debt.

The government's own study predicted last year that within 5 years, 39% of the exchanges will only have one Insurer left in them. That means a "monopoly," with more exchanges sure to follow. In fact, I wouldn't be surprised if the Insurance Companies decide which areas of the country they want to dominate, drop out of all the other exchanges, and focus all their resources on their "target" exchanges to drive out competitors. Once the desired monopolies develop, they will isolate the Congressmen & Senators from those states and lobby them to maintain those monopolies. There is money to be made in all this; it's just taking some time to shake out.

Most people will not care. After all, most people are not on the exchanges, and most Americans don't feel personally responsible for the National Debt. Liberals will feel happy the poor have "coverage," and we'll just tack the cost onto our borrowing. "We can find the money to fight wars; we will find the money to Cover the Poor."

And I believe Conservatives are powerless to stop this. The insurance companies knew what they were doing when they helped write this bill.

While I found this to be a compelling prognostication, you don't think immediate full repeal would stop its fruition? I believe you are right about the danger, in that the AMA and the AHA could get behind such ideas since they would not derail the gravy train. That is why I think full repeal ASAP is an important first step

 

[Libertarian01]

Oh. One other thing. Remember when Obama browbeat Justice Roberts, and said the ACA was passed by congress with bipartisan support? That's only technically true. Not one Republican ever voted for any bill with the text of Obamacare. The original House bill that had passed unanimously, was a bill for veterans. THAT's the bill Republicans supported.

****ing liars.

You touch on one of the modern issues with law writing - the Conference Committee.

The conference committee serves an extremely useful purpose, but has way too much power and is not understood by the American people.

So bills are introduced in both the House and the Senate. In theory, they should be covering generally the same issue such as defense spending, highways, federal pension reform, etc.

Let's say that the bill we are going to talk about is what Congress is going to eat for lunch in June. The House votes to have their bill have beer and pizza, but the Senate is more uppity than that. The Senate votes to have their bill have steak and wine for lunch. Both bills are actually similar in that they are covering appropriations for lunch, but they do not agree 100%. Now it goes to conference committee. In a normal conference committee they might say beer and pizza for the first two (2) weeks and steak and wine for the last two (2). Or they could fully compromise and say pizza and wine. But what folks don't realize is that they could say, "Ya know, we haven't had seafood in awhile, so let's have fish & chips along with iced tea." Now the bill is sent back to the House and Senate to re-vote on, then to El Presidente to sign presuming it passes.

The worst part is that the folks on the conference committee could decide that voting on lunch isn't important at all, but change the entire bill fund buying and training 10,000 police dogs AND IGNORE LUNCH ALTOGETHER!

When the bill gets back to both houses a few folks will say WTF, while the rest decide we should have police dogs and sign it anyways. Some of this comes from pressure from their constituents to not F around, and of course all the police departments will come out fully supporting the Congressional Lunch Act that will lower crime and save lives. What are legislatures supposed to do, tell the LE community to F off?

Now the conference committee is political, so it normally won't push things too far to avoid big blowback. They do have to try to be reasonable about it, mostly. But if the house and senate leadership are in agreement on getting something through and it is both their people on the committee, then the passage is almost guaranteed. El Presidente could veto it, but why would he? He doesn't give a bugs butt if the Congress has lunch or not and he doesn't want the pressure from the LE community, 'cause all the politicians support law & order, right?

The conference committee is a powerful committee to be on, and I'll bet a nickel that the house and senate leadership both pick folks to be there that are long term party loyalists, who aren't too extreme on anything. So the republicans wouldn't normally pick someone like Ted Cruz and the democrats wouldn't pick someone like Diane Feinstein. They want folks that will do what they're told when they're told. I'm certain a few extremists slip through by accident, but not many.

Regards,

Doug

 

[Twangbanger]

While I found this to be a compelling prognostication, you don't think immediate full repeal would stop its fruition? I believe you are right about the danger, in that the AMA and the AHA could get behind such ideas since they would not derail the gravy train. That is why I think full repeal ASAP is an important first step

Of course, I believe full repeal is the "right" approach to forestall my described scenario. But if there's one principle in which the American public has shown bed-rock belief, it is that above all else, entitlements ought not be taken away _after_ they're granted, regardless how questionable the circumstances of their implementation. And in addition to that obstacle, we now face entrenched lobbies in the AMA and Insurance Companies, who face loss of future profits if these benefits are repealed. In America, you get insurance through your job, and beginning in 2008, a _lot_ of people lost their jobs. Obamacare brings those "lost customers" back to the Insurance Companies. With ACA, the Industry can continue to "Party like it's 2007." At taxpayer expense.

I ask my Conservative friends who believe the exchanges are doomed to fail, the following question: name for me a single federally-backed, taxpayer-subsidized entity which has ever failed, dried up and gone away? They're so dead-set on their pet belief that ACA was intended to "default" to Single-Payer, that they fail to see the much more likely scenario right in front of them: a "Military-Industrial Complex" in Health Insurance, entrenched by lobbying, and which needs no further legislation to achieve. Single-Payer gives corporations nothing to lobby for. But a "Military-Industrial Complex" arrangement, with Insurance Companies as the contractors, will bring suitcases full of lobbying cash for ever & ever.

As for the Republicans' role in this, have you heard the expression, "Why buy the cow, when you can get the Milk for free?" Obamacare Repeal was the "cow," a political issue to be exploited for winning elections (the "milk"). Republicans now own all the "milk." They've taken control of every part of Washington D.C. that can possibly be gained by winning elections. The GOP does not need the "cow" anymore. The "prize" has already been awarded.

 

[BugI02]

Agreed, and as I've stated previously, curtailment/ending of abortion fits the same pattern. 1) "Send me to congress and I will end the scourge of abortion" 2) "Re-elect me so I can continue my fight to end the evils of abortion"
3)" We are closer than ever, send me back to congress to complete the fight to end abortion once and for all" Lather, Rinse, Repeat

So many people when they reach the pinnacle of politics become consumed primarily with staying there, and these 'battles' provide them with the effective means of achieving those ends. But, as one wag said " 'You go to war with the army you have, not the army you might want or wish to have at a later time."

My hope rests on the realization that the Lord can accomplish great things with flawed tools; and no matter what, we are still better off than we would have been under the Hag

 

[Ericpwp]

You forgot send me money.

 

[Twangbanger]

Agreed, and as I've stated previously, curtailment/ending of abortion fits the same pattern. 1) "Send me to congress and I will end the scourge of abortion" 2) "Re-elect me so I can continue my fight to end the evils of abortion"
3)" We are closer than ever, send me back to congress to complete the fight to end abortion once and for all" Lather, Rinse, Repeat...

I think people on the "Right" are (now) aware of the fustercluck we're in. Justice Roberts hosed us. What's going to take more time, is for Liberals to realize how badly they're screwed.

Liberals are going to spend 6 months celebrating non-repeal of the law, another year anticipating the midterms, then the next two years searching for a "Bernie" candidate to promise them Single-Payer. It will be at least 4 years before they reach the conclusion I've / we've reached: that Obamacare is an entrenched government-industry partnership designed to create revenue flows to insurance companies. And the Republicans now have 4 years of full control, with lobbyists knocking on their office doors every day, to entrench the arrangement.

"Coverage for the Poor" was the bait used to lure Progressives in. Afterward, Conservatives spent 6 years thinking "We'll get Repeal." Liberals will now spend another 4 thinking, "We'll get Single-Payer." We will be a full decade into entrenchment of this Military-Industrial complex, before both sides fully realize that absolutely nothing can be done about it. "Everybody" will have coverage, Insurance Companies will be the Government Contractors for implementation, and all the damages of that promise/arrangement will accrue to the National Debt. Once everybody's "nut is covered," there will not be any one single constituency with enough pull to successfully push for Single-Payer.

So don't celebrate too hard, Liberals. It turns out your last hope for the system you wanted, was the same as Conservatives': Justice Roberts striking the current law down. He was a reliable vote for corporate oligarchy. While you were celebrating Obama's historic Supreme Court victory, he was laying the final brick of a new Military-Industrial complex right under your noses. Obamacare isn't going to be the downfall of your much-hated enemy, the Insurance Companies; to the contrary, it's going to ensure their existence forever.

 

[BugI02]

The frightening thing is I've heard and read politicians show-casing the fact that the healthcare industry is experiencing record growth in employment and in some areas is the largest employer. I even heard one clueless liberal on NPR saying healthcare was the new manufacturing and people should retrain to seek jobs there. Healthcare manufactures nothing and adds nothing to the economic bottom line, it is only a drag on the overall economy (though a somewhat necessary one). No one seems aware (or at least willing to admit) that there is a hard upper limit to the share of the economy that health care can absorb before it all comes off the rails

Sometimes, in my more cantankerous moments, I think it should be turned into a regulated monopoly like water and electricity. The 'all the traffic will bear' mentality for something everyone will need eventually bothers me.