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Author Topic: The Politics of Health Care  (Read 397723 times)
Crafty_Dog
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« Reply #1600 on: June 05, 2017, 12:00:56 PM »

https://mises.org/blog/lower-health-care-costs-try-freedom
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G M
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« Reply #1601 on: June 05, 2017, 01:56:45 PM »


No opportunities for graft and rent-seeking with freedom. That's why politicians frown on it.
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DougMacG
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« Reply #1602 on: June 13, 2017, 12:41:25 PM »

Dropping at a rate of 4 million per year.  Dropping faster left in place than CBO predicted under repeal.

http://freebeacon.com/issues/1-9-million-obamacare-cancellations/
« Last Edit: June 13, 2017, 01:09:18 PM by DougMacG » Logged
G M
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« Reply #1603 on: June 13, 2017, 02:50:40 PM »

Dropping at a rate of 4 million per year.  Dropping faster left in place than CBO predicted under repeal.

http://freebeacon.com/issues/1-9-million-obamacare-cancellations/

They had to pass it to find what's in it.
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ccp
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« Reply #1604 on: June 24, 2017, 08:54:34 PM »



Making the House Health Bill More Conservative
By Bobby Jindal
 
President Trump has finally achieved unity and consensus in our nation’s capital. Pundits, Republican and Democrat members of Congress, and the media all seem to agree that everything must stop so that we can endlessly speculate on Russia, special counsels, the FBI, the last election, and criminal charges. Nonsense. Voters elected President Trump and the Republican majorities in Congress to drain the swamp, i.e., to make big and fundamental changes in the direction of our country. Let Mueller, and the appropriate Congressional committees, talk to Comey, Flynn, and even Putin if they want, but in the meantime, do not let Democrats run out the clock. Our country faces too many dire challenges, thanks in large part to the Obama years, that must be addressed now. Congress is, despite its earned reputation, actually capable of walking and chewing gum at the same time. I have a radical idea – why don’t our political leaders do what they promised when they asked for our votes just a few months ago? They could start by actually repealing and replacing Obamacare.

Now that the House has finally passed its health care legislation, attention turns toward the Senate. House leadership claimed certain popular provisions could not be added, e.g., allowing the sale of insurance across state lines, and other unpopular provisions could not be removed, e.g., the special treatment for Members of Congress and their staff, to ensure rapid Senate approval of the House legislation. Despite these assurances and compromises, Republican Senators are now talking about writing their own legislation. While the House compromise that allows states the option to apply for a federal waiver to repeal many of Obamacare’s regulations disappointed conservatives wanting a full repeal, early indications from the Senate are their changes will be to make the legislation less and not more conservative. (Indeed, why not at least require states to apply to keep, rather than to replace, Obamacare’s regulations?)

Senate Republicans should adopt as their guideposts the conservative goals of reducing federal spending, dependence on subsidies, and government intrusion. President Obama’s unprecedented Medicaid expansion to cover millions of able bodied adults violates all three. It wasn’t that long ago when Republicans were in near unanimous agreement that reducing welfare rolls, through policies like time limits and work requirements, was a positive thing. A safety net should be provided for the neediest amongst us, but it should be temporary, targeted, and locally governed.

Senate Republicans should strengthen the House bill’s provisions by giving states even more flexibility to design and run their Medicaid programs. Multi-year federal grants for states should be tied to some measures of eligibility, but not simply to enrollment. Just as states currently benefit when they reduce their welfare rolls, they should not be rewarded for keeping people on Medicaid longer than necessary or punished for encouraging individuals to afford private coverage. States should also have the flexibility and financial incentives to design wrap-around coverage or premium assistance plans rather than one size fits all benefits packages that often crowd out private coverage. Current rules technically allow but actually discourage states from pursuing such policies. A beneficiary with employer provided or individual coverage might require targeted assistance, for example, affording prescription drugs or cost sharing, but should not have to choose between keeping their private coverage and getting help.

Just as the House bill gives states the option to manage their own individual insurance marketplaces, as they did before Obamacare, so should the Senate give states the ability to manage their own Medicaid programs. States should no longer have to come begging to Washington to design benefit packages, cost sharing provisions, or eligibility requirements that meet the unique needs of their constituents. Washington can and should require accountability through overall performance measures, to ensure states are focused on improving health outcomes and not just complying with complicated rules, and special protections for the most vulnerable populations, e.g., the elderly and disabled.

A second conservative change would be for the Senate to transform the House’s refundable tax credit into a tax deduction. This would have to be accompanied by funding for state designed programs to assist needy individuals who do not earn enough income to pay taxes and benefit from the deduction, but at least this subsidy would be explicitly identified as spending and could thus be managed, rather than hiding a new federal entitlement program in an increasingly complicated tax code. A deduction would incentivize consumers to buy health care more efficiently, as they would keep the savings, and insurers and providers to compete to reduce costs. Independent scoring of this provision previously has shown it to be one of the more effective ways to “bend the cost curve down.”

Conservatives have waited many years to repeal and replace Obamacare. Perhaps it is too ambitious to hope the Senate improves the House legislation, rather than merely playing defense and trying to minimize the ways they will make it worse. However, President Obama himself campaigned on the promise to be transformational and not merely incremental – surely, we should aim no lower.
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G M
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« Reply #1605 on: June 25, 2017, 08:30:11 PM »

https://www.youtube.com/watch?v=UIXK2cjcbPg


http://www.cbsnews.com/news/los-angeles-veterans-affairs-hospital-patients-died-waiting-for-care/?ftag=CNM-00-10aab8a&linkId=39052106

Nearly 100 patients died waiting for care from Los Angeles VA

LOS ANGELES -- President Trump signed a bill today giving top-ranking officials at the department of Veterans Affairs more power to fire incompetent workers and protect whistle-blowers. The agency has struggled to provide health care and other services to military veterans.

The legislation was prompted by a 2014 scandal at the Phoenix VA medical center, where many veterans died while waiting months to see a doctor.

The problem was even worse at the Los Angeles VA hospital, CBS News correspondent Melissa Villarreal reports.

A new report by the VA inspector general shows 43 percent of the 225 patients who died between October 2014 and August 2015 at the Los Angeles VA were waiting for appointments or needed tests they never got. However, the report does not conclude these patients "died as a result of delayed consults." 

Susan and Allen Hoffman were happily married for 43 years -- but Allen, a U.S. Navy veteran, was living in pain.

"He had an enlarged prostate and they just kept saying it's not a problem you know, whatever, and then, it started to get worse," Susan says.

He was scheduled to see a specialist in May 2013, but she says that didn't happen.

"She said, 'No, you're here just for a consult. You have to understand people have cancer and he doesn't,'" Susan Hoffman says. "I think we were there for 15 minutes."

Four months later, Hoffman was diagnosed with stage IV prostate cancer.

Dr. Christian Head is a surgeon at the Los Angeles VA. He says 140,000 patient consults were deliberately deleted.

"The number of patients waiting for care, the deletion of consults, and the wait list were much more significant here than at Phoenix," Head says.

"I first noticed an unusual number of patients who are presenting with delay in diagnosis, meaning that they present into the system, they disappeared for a number of years and then they presented late with advanced cancers. Those consults were being deleted, literally removed from the system," Head says.

Allen Hoffman died a year and a half after he was diagnosed. The VA has settled out of court with his widow.

"Was there any doubt in your mind that they were responsible for your husband's death?" Villarreal asked.

"Definitely they were," Susan Hoffman says.

The VA would not comment about Hoffman's case or Head's allegations, but Los Angeles' hospital director admits the problems in the report are serious.

To fix them, they've hired new leadership, are retraining employees and now posting wait times on-line.
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DougMacG
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« Reply #1606 on: June 26, 2017, 10:38:33 AM »

About as good as the rest of the promises, you can keep your doctor, your plan, costs will go down $2500 per family, insured 24 million fewer than CBO predicted, "won't add one dime to the deficit", will not raise taxes on the middle class. etc.

'Can we all say it together - Unexpectedly!'

http://www.beckershospitalreview.com/finance/er-visits-by-medi-cal-patients-up-75-under-aca-data-says.html

ER visits by Medi-Cal patients up 75% under ACA, data says
Written by Alia Paavola | June 12, 2017

Despite predictions that the ACA would ease the strain on emergency rooms, the number of ER visits by Medi-Cal patients rose 75 percent over five years, according to data released by California's Office of Statewide Health Planning and Development.

ACA advocates argued ER visits would decrease once people received health coverage since they could afford to see primary care physicians instead. However, ER visits by California's Medicaid population jumped from 800,000 in the first quarter of 2012 to 1.4 million in the final quarter of 2016, according to the data.
--------------
Also see:
http://www.dailywire.com/news/14725/7-key-promises-obamacare-broke-aaron-bandler#
-------------
"you're going to be able to choose your doctor and not have to go through some network in an emergency situation as a consequence of these rules."
"What happens is, you don't have health insurance, you go to the emergency room. You weren't getting a checkup; something that might have been curable with some antibiotics isn't caught. By the time you get to the hospital, it's much more expensive. The hospital cares for you because doctors and nurses, they don't want to just turn somebody away. But they've got to figure out how do they keep their doors open if they're treating all these people coming into the emergency room."
"that's not fair, because all the rest of us are going to be paying for those folks when they go to the emergency room"
   - President Barack Obama, September 22, 2010
http://www.presidency.ucsb.edu/ws/?pid=88480
« Last Edit: June 26, 2017, 10:56:19 AM by DougMacG » Logged
Crafty_Dog
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« Reply #1607 on: June 27, 2017, 11:08:22 AM »

Among the howls and yowls over the Senate bill about cutting Medicare blah blah I discovered some fascinating factoids.

*Actual Medicare spending will go UP 18%.  The purported "cuts" are but baseline cuts.

*As we here already know, it is a serious misnomer to define the decrease in enrollee numbers as a matter of people being kicked out of coverage.  In point of fact many/most are returning to what they did before Obamacare compelled them to join.  Furthermore, because the CBO must use the data fed to it (GIGO=Garbage In Garbage Out) apparently it is required to assume 7 million more enrollees than are actually there?!? (Don't have citation for this).  Anyway, in this vein, here is this: http://www.nationalreview.com/article/448991/senate-health-care-bill-will-reduce-coverage-15-million-good

No doubt there is much more malarkey of this sort out there , , ,
« Last Edit: June 27, 2017, 11:24:21 AM by Crafty_Dog » Logged
Crafty_Dog
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« Reply #1608 on: June 30, 2017, 03:27:26 PM »

https://www.wsj.com/articles/senators-urge-trump-to-back-wholesale-obamacare-repeal-if-gop-bill-fails-1498825462
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G M
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« Reply #1609 on: July 02, 2017, 03:19:22 PM »

Remember, you belong to the state. Don't get any funny ideas...



https://pjmedia.com/parenting/2017/06/29/baby-charlie-denied-life-by-british-health-system-eu-courts/

Baby Charlie Denied Life by British Health System, EU Courts
 BY JEFF REYNOLDS JUNE 29, 2017 CHAT 155 COMMENTS

On June 27, the parents of 10-month-old Charlie Gard lost their final appeal to travel to the United States to have him treated for a rare brain disorder. The European Court of Human Rights (EHCR) denied the appeal of London parents Chris Gard and Connie Yates, which means that his life support will be removed and, at some point, he will be allowed to die.

Charlie's parents raised over £1.4million in private donations via GoFundme to pay for the treatment and their travel expenses. Charlie Gard suffers from a mitochondrial disease that causes muscle weakness and brain damage. His parents wanted to bring him to the United States for experimental nucleoside treatment, but the administrators and doctors at Great Ormond Street Hospital for Children denied the request. Their alternative? Withdraw life support, administer palliative care, and let Charlie "die with dignity."

Let that sink in a minute: This treatment would have come at no cost to the hospital or the National Health Service (NHS), and would have been covered completely by private donations. They denied the parents their right to determine care for their own child.


Notably, nucleosides are prevalent in breast milk, but in an interview, the couple said they had been denied the ability to give Charlie breast milk while in hospital:

   YouTube ‎@YouTube
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 LG @laurakinz
Nucleosides are abundant in unpasteurized breast milk but Charlie isn't allowed it https://youtu.be/wHROVTovpo0  #charliesfight #breastisbest
1:46 PM - 22 Jun 2017
  27 27 Retweets   30 30 likes
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That's right. The hospital refused to allow the mother to breast feed her child and refused to allow them to seek alternative treatment on their own dime, at no cost to taxpayers.

Chris and Connie filed appeal after appeal, all the way up to the Supreme Court. The courts sided with the doctors and hospital administrators each time.

The parents are reportedly "utterly distraught." Social media reactions to the decision were heart-wrenching.

27 Jun
 Evening Standard  ✔ @standardnews
European court rejects Charlie Gard parents' plea to intervene in case http://www.standard.co.uk/news/london/charlie-gard-european-court-rejects-parents-plea-to-intervene-in-battle-to-save-terminally-ill-baby-a3574436.html
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 Catholic State Org. @LaCatholicState
@standardnews very evil people.....$entencing a child to death! What an anti-child pagan $ociety we are. I pray for #CharlieGard!
9:34 AM - 27 Jun 2017
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 Bev @bevvyboo22
@Fight4Charlie his amazing parents couldn't have fought any harder - a system that has lost its soul should be ashamed of this decision
9:48 AM - 27 Jun 2017
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 TomDUK @TomDUK1
The #CharlieGard case is terrible. Shame on the UK judges allowing him to die, shameful, terrible decision.
9:34 AM - 27 Jun 2017
  126 126 Retweets   230 230 likes

The decision by the EHCR was as cold as it was final:

Today the European Court of Human Rights has by a majority endorsed in substance the approach by the domestic courts and thus declared the application inadmissible. The decision is final.

The case concerned Charlie Gard, a baby suffering from a rare and fatal genetic disease.

In February 2017, the treating hospital sought a declaration from the domestic courts as to whether it would be lawful to withdraw artificial ventilation and provide Charlie with palliative care.

Charlie's parents also asked the courts to consider whether it would be in the best interests of their son to undergo experimental treatment in the US.

The domestic courts concluded that it would be lawful for the hospital to withdraw life sustaining treatment because it was likely that Charlie would suffer significant harm if his present suffering was prolonged without any realistic prospect of improvement, and the experimental therapy would be of no effective benefit.

The domestic court decisions had been meticulous, thorough and reviewed at three levels of jurisdiction with clear and extensive reasoning giving relevant and sufficient support for their conclusions; the domestic courts had direct contact with all those concerned.

The domestic courts had concluded, on the basis of extensive, high-quality expert evidence, that it was most likely Charlie was being exposed to continued pain, suffering and distress and that undergoing experimental treatment with no prospects of success would offer no benefit, and continue to cause him significant harm.'

Did you notice that? High-quality experts meticulously determined that staying alive would offer no benefit and would continue to cause Charlie significant harm. His parents were removed from the equation entirely by a single-payer health care system -- the NHS -- and bureaucrats who know better.

 
Of course, we already know that the bureaucrats who know better are motivated as much by fiscal concerns as medical concerns. I've written many times about QALY -- Quality Adjusted Life Years -- the model that helps bureaucrats determine how many healthy, taxpaying years a patient has left so that they can pay back into the system. It's basically a determination of the return on investment on providing care. If you don't show enough ability to pay back into the system over a prolonged lifetime, care is denied.

Hospital administrators insisted that their decision was humane -- to allow Baby Charlie to "die with dignity." One wonders, however, if in the bowels of the bureaucracy it was determined that the poor boy was likely to suffer from permanent brain damage, and thus become too heavy a burden on society.

Another similar case is playing out in Liverpool. Alfie Evans is a 13-month-old baby in a coma. He's been unconscious since December, and his parents now believe they will face a similar legal fight just to keep their baby alive. No diagnosis has happened, and no prognosis for the future has been offered. The baby showed signs of delayed development, but doctors dismissed him as a late bloomer. He subsequently suffered seizures and slipped into a coma and has been unconscious ever since.


The doctors are applying increasing pressure on Alfie's parents to turn off life support.

Death panels have been operating in Great Britain for some time, and reports indicate that the quality of care is further deteriorating in the NHS. It's incumbent upon every member of our society to determine what we're going to do about this -- both in Great Britain and in America. The Independent Payment Advisory Board (IPAB) is Ezekiel Emanuel's creation that brings health care rationing to America under Obamacare. Should we fail to act, these ghoulish horrors are what await us too.
« Last Edit: July 02, 2017, 09:17:08 PM by Crafty_Dog » Logged
DougMacG
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« Reply #1610 on: July 10, 2017, 08:45:15 AM »

https://www.americanactionforum.org/research/update-obamacares-impact-small-business-wages-employment/
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Crafty_Dog
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« Reply #1611 on: July 10, 2017, 12:57:13 PM »

http://www.nationalreview.com/article/449296/ted-cruz-mike-lee-obamacare-repeal-amendment-sound-policy
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DougMacG
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« Reply #1612 on: July 10, 2017, 01:16:34 PM »


It looks good to me.
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Crafty_Dog
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« Reply #1613 on: July 13, 2017, 05:07:14 PM »

https://pjmedia.com/trending/2017/07/13/doj-arrests-hundreds-in-largest-combined-health-care-fraud-case-in-history/
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ccp
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« Reply #1614 on: July 13, 2017, 07:00:33 PM »

https://www.conservativereview.com/articles/freedom-and-the-gop-are-dying-under-leader-mcconnell
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ccp
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« Reply #1615 on: July 13, 2017, 07:02:32 PM »

Crafty Dog post

Frankly the doctors who are involved in these schemes have always been obvious to those of us in the healthcare field

https://pjmedia.com/trending/2017/07/13/doj-arrests-hundreds-in-largest-combined-health-care-fraud-case-in-history/
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G M
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« Reply #1616 on: July 14, 2017, 02:41:18 PM »

http://ace.mu.nu/archives/370663.php

July 14, 2017
Judge to Allow US Specialist to Examine Charlie Gard
As Ed Morrissey notes, Time magazine (but are they really a magazine?) either credits, or blames, conservatives with pushing this issue out from under the smother blanket of leftwing media embargo.

I don't like that just one guy is being asked his opinion -- I'd rather have two - and I would like it less if, as I'd assume, the Judge, who seems to have a nearly personal stake in this dispute, didn't get to pick the expert here.

Per Time magazine (Huh), here is how one of Britain's many worthless #FakeChurch clergymen responded:

Thomas Williams, an Auxiliary Bishop for the British city of Liverpool, questioned the motives of some external actors. “It’s a terrible situation for both the family and the hospital,” he told TIME. “I’ve always accepted, as a priest and a hospital chaplain, that people need to be allowed to die and sometimes nature needs to take its course. The right-wing element of these evangelicals, I’m afraid I’m not down that line at all… I can’t read their minds, but I do think that people will stand on soapboxes when situations arise.”
Here's my take:

I am not a strong sentimentalist, though I do have some sentimentalism in me. I am not a life-absolutist -- there are many cases in which I'd say a life isn't worth fighting for. If the person is in pain, and his death is inevitable -- I'd say it's a justifiable position to pull the plug.

But note the very large difference between a "justifiable" decision and a mandatory one. If the people who the law has previously put in charge of these decisions -- the people closest to the stricken patient, who usually have the most love and affection for him -- made this choice, I wouldn't agree with that choice, but only because I would not have even heard of this choice -- such decisions are made every single day, and no one hears about them, and no one judges them much either way.

But in this case, the parents -- who are the most physically, emotionally, and spiritually conntected to Charlie Gard -- have expressed their strong desire to fight for the kid's life, and it's a bunch of disinterested beancounters and bureaucrats, and one judge who really seems to take "playing God" as the ultimate in judgecraft -- who are deciding he must die. Or, as the National Laughingstock would say, "must be permitted to die," as if Charlie Gard is desperately fighting for his right to die in dignity, and his square bullying parents are fighting him over this.

I doubt many people have illusions about Charlie Gard's ultimate fate: He will almost certainly die, whether by state mandated euthanasia or the natural (and often cruel) betrayals of biology, and even if he lives, it will not be for long, and even if he lives, the chances of him having much of a functioning mind are quite low.

That's my opinion. That's the opinion of the NHS and this judge.

We all have opinions. As the man said, they're like assholes. We've all got 'em, and most of them stink pretty foully.

But we are not the people to make this decision. We are not the people whose opinions count.

The opinions that count belong to this kid's flesh-and-blood parents, the ones who made him, the ones who have cared for him and suffered with him since birth.

What is the irreversible harm that will occur if Charlie Gard is permitted a few more days in this world, which may be -- for a nonbeliever like myself -- the only world he will ever exist in?

Is he in great pain? They seem to be saying he's in vegetative state; how then would he feel pain?

Death is irreversible. Unlike a reporter manufacturing news and getting stories 100% wrong, there is no Free Pass for death. There's no coming back from it.

My general instinct is that you give hope a chance.

Hope is often a silly thing. And hope often leads to hearbreak.

And yet, without hope, there is no humanity. Literally. I don't mean that metaphorically -- I mean that hope is a key component of the human survival instinct.

What does a man do without hope? Why would he carry on in a world that is usually pretty tough and often sad?

Well, he'd kill himself. Killing himself would be the rational choice for a man without hope.

Hope is often irrational -- but it is the irrational things like love, a desire to have children who you'll have to care for 20 years (or more), and who may, God forbid, die before you do and break your heart harder than you could have ever imagined, and hope for a better tomorrow that has kept this species from not simply committing mass suicide 100,000 years ago.

The parents are choosing hope. The parents are the natural (as the law would say) guardians and custodians of this child. The parents make the decisions for this child, even if disinterested third-parties might disagree with their opinion.

It's their fucking kid, man. What is so hard to grasp about this?

Here's a fact of biology: When a living thing is stricken and can endure no more, it will allow itself to die.

When someone is in critical condition, and family members ask if he'll pull through, doctors will sometimes ask, "Is he a fighter?"

Some will cling to life longer; some will find the anguish too much, and their bodies will just shut down.

I don't see much of a downside in letting Charlie Gard decide how much fight he has in his little stricken body.

I do see an enormous downside in taking such an intensely personal decision out of the hands of the mother -- don't progressives tell us that mothers, and only mothers, may decide if a child shall live or die? -- and hand it over to beancounting bureaucrats and unaccountable politicians-in-robes.

By the way, I don't totally have anything against the hospital bureaucrats for having a different point of view on this than the parents. As hospital workers, they work in -- let's face it -- a place where many people come to die. It's just a sad fact of their profession --they will see many, many people die. They will see more people die than pretty much anyone, even soldiers.

So they have a (useful, and well-earned) professional detachment about death. They do have a kind of hardened wisdom about life-and-death that most of us do not.

I can understand their feeling, as they've felt about a thousand very ill patients before, that there is no hope here, and that it's time for the baby to die.

What I cannot understand is their determination that their feeling should override the parents' feeling.

Okay, NHS: This is your ten millionth death. I understand -- without being negative about it -- that you are not particularly emotional about your ten millionth death.

Can you understand that this is these parents' first death? Certainly the first death of a child!

I'm not religious, but I am pro-human, and to me, that means understanding that human beings are hardwired for hope (otherwise, as I said, the race would have simply chosen to kill itself 100,000 years ago), and that, even to a not-particularly-sentimental-about-such things, nonbelieving, cynical realist, is a precious and fragile thing which is worth rolling the dice on and worth giving a chance.

That's my opinion.

It's also my opinion that they're just delaying the heartbreak, and, by allowing themselves to be filled with hope, they're going to feel even more heartbreak.

Because hope does that. Hope may lift you, but it sometimes lifts you up just so you can fall further and harder.

That's the nature of the thing.

So those are my opinions.

But who gives a shit about my opinions on it?

My opinion doesn't matter.

If the parents chose to take their kid off life support, my opinion still wouldn't matter.

The parents, the only two people in this world who have an elemental and primal and truly emotional attachment to this kid, have decided its in his best interest to give him a chance.

And as long as they're saying that: Who the fuck has so arrogated himself to sit in the throne of God Himself to claim the right to say otherwise?
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ccp
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« Reply #1617 on: July 18, 2017, 08:23:49 AM »



watch the feckless Repubs never
get it out of the House or it will die in Senate as soon as McCain gets back.

http://www.newsmax.com/Politics/congress-budget-plan-cuts/2017/07/18/id/802213/
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Crafty_Dog
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« Reply #1618 on: July 23, 2017, 09:15:51 PM »

http://thehill.com/policy/healthcare/343222-what-trump-can-do-to-cripple-obamacare
« Last Edit: July 24, 2017, 08:01:25 AM by Crafty_Dog » Logged
G M
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« Reply #1619 on: July 23, 2017, 10:21:41 PM »


Let it burn.
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Crafty_Dog
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« Reply #1620 on: July 25, 2017, 03:43:43 PM »

Brilliant Move By Gop On Health Care Bill
By DICK MORRIS
Published on DickMorris.com on July 25, 2017
Senate Majority Leader Mitch McConnell is pulling a rabbit out of a hat by redefining what constitutes a rabbit and what is a hat.

Everyone assumed that the procedural motion to vote and bring an end to the health care debate was simply a precursor to passing the final bill.  But it was McConnell's genius to realize that it is a separate vote with its own momentum and its own context.

He realized that while the Republican Senators could not agree on what was the solution, they all agreed that one was needed.  So he floated three different ideas in order to get the Senators to vote to close debate and vote on something:
 
1.  The Full Monty -- A full repeal and replace bill.

2.  A Half Monty -- Just repeal.

3.  A Bland Monty -- Just repeal the mandate that people have to buy insurance and some of the tax hikes.

With such a broad array of choices, every Republican could find something he could vote for and use that to justify his vote to close debate.

Once the closure motion passes, then the real bargaining will begin.  Why will it succeed now?

McConnell is betting, perhaps wisely, that the momentum of the closure vote will carry over and that, at least, the mandate bill (Option 3) will pass.

President Trump and the GOP leaders rightly reckon that the requirement is to pass something and repeal some of Obamacare.  Passing anything will give Trump momentum and a reprieve and will give Republicans something to cheer about.

Back in the days when Obama was president, Republicans passed a bill stripping the mandates and leaving the rest of the Obamacare in tact.  He killed it with a veto threat, but if it was good enough for the Republicans back then, its good enough now.

Without the mandate, Obamacare cannot survive.  People will not pay its outrageous premiums unless they must.  6.5 million taxpayers paid a fine last year -- totaling $3 billion -- for not having health coverage.  The average fine was $470. Once the mandate is lifted, those folks are not going to buy insurance and many who have knuckled under an paid for plans they don't want will flock away.

To save the insurance industry, it will then be essential to permit the sale of more limited plans to bring down prices.

Obama always said that if you abandoned the mandate, the whole structure would fall apart.  He was and is right.

So, let's do it!
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Crafty_Dog
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« Reply #1621 on: July 27, 2017, 11:02:32 PM »

http://www.speroforum.com/a/FCTILKZKGM55/81414-Mark-Levin-Republican-liars-pulled-biggest-hoax-in-modern-times?utm_medium=email&utm_campaign=KRPZFGZOJH43&utm_content=FCTILKZKGM55&utm_source=news&utm_term=Mark+Levin+Republican+liars+pulled+biggest+hoax+in+modern+times#.WXq2-3okS2A
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DougMacG
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« Reply #1622 on: August 02, 2017, 05:18:45 PM »

Greg Mankiw goes over some of the basics.
https://www.nytimes.com/2017/07/28/upshot/why-health-care-policy-is-so-hard.html

Why Health Care Policy Is So Hard
Economic View
By. GREGORY MANKIW JULY 28, 2017

“Nobody knew that health care could be so complicated.” President Trump said that in February, yielding more than a few chuckles from pundits and late-night comedians.

In fact, anyone who has spent some time thinking about the issue sees its complexity. With the collapse of the Senate health care bills this week, the president has certainly been reminded of it.

But Mr. Trump’s epiphany raises some questions: Why is health care so complicated? How does it differ from most of the other goods and services that the economy produces? What makes health policy so vexing?

In Econ 101, students learn that market economies allocate scarce resources based on the forces of supply and demand. In most markets, producers decide how much to offer for sale as they try to maximize profit, and consumers decide how much to buy as they try to achieve the best standard of living they can. Prices adjust to bring supply and demand into balance. Things often work out well, with little role left for government. Hence, Adam Smith’s vaunted “invisible hand.”

Yet the magic of the free market sometimes fails us when it comes to health care. There are several reasons.

Externalities abound. In most markets, the main interested parties are the buyers and sellers. But in health care markets, decisions often affect unwitting bystanders, a phenomenon that economists call an externality.

Take vaccines, for instance. If a person vaccinates herself against a disease, she is less likely to catch it, become a carrier and infect others. Because people may ignore the positive spillovers when weighing the costs and benefits, too few people will get vaccinated, unless the government somehow promotes vaccination.

Another positive spillover concerns medical research. When a physician figures out a new treatment, that information enters society’s pool of medical knowledge. Without government intervention, such as research subsidies or an effective patent system, too few resources will be devoted to research.

Consumers often don’t know what they need. In most markets, consumers can judge whether they are happy with the products they buy. But when people get sick, they often do not know what they need and sometimes are not in a position to make good decisions. They rely on a physician’s advice, which even with hindsight is hard to evaluate.

The inability of health care consumers to monitor product quality leads to regulation, such as the licensing of physicians, dentists and nurses. For much the same reason, the Food and Drug Administration oversees the safety and effectiveness of pharmaceuticals.

Health care spending can be unexpected and expensive. Spending on most things people buy — housing, food, transportation — is easy to predict and budget for. But health care expenses can come randomly and take a big toll on a person’s finances.

Health insurance solves this problem by pooling risks among the population. But it also means that consumers no longer pay for most of their health care out of pocket. The large role of third-party payers reduces financial uncertainty but creates another problem.

Insured consumers tend to overconsume. When insurance is picking up the tab, people have less incentive to be cost-conscious. For example, if patients don’t have to pay for each doctor visit, they may go too quickly when they experience minor symptoms. Physicians may be more likely to order tests of dubious value when an insurance company is footing the bill.

To mitigate this problem, insurers have co-pays, deductibles and rules limiting access to services. But co-pays and deductibles reduce the ability of insurance to pool risk, and access rules can create conflicts between insurers and their customers.

Insurance markets suffer from adverse selection. Another problem that arises is called adverse selection: If customers differ in relevant ways (such as when they have a chronic disease) and those differences are known to them but not to insurers, the mix of people who buy insurance may be especially expensive.

Adverse selection can lead to a phenomenon called the death spiral. Suppose that insurance companies must charge everyone the same price. It might seem to make sense to base the price of insurance on the health characteristics of the average person. But if it does so, the healthiest people may decide that insurance is not worth the cost and drop out of the insured pool. With sicker customers, the company has higher costs and must raise the price of insurance. The higher price now induces the next healthiest group of people to drop insurance, driving up the cost and price again. As this process continues, more people drop their coverage, the insured pool is less healthy and the price keeps rising. In the end, the insurance market may disappear.

The Affordable Care Act (a.k.a. Obamacare) tried to reduce adverse selection by requiring all Americans to buy health insurance or pay a penalty. This policy is controversial and has been a mixed success. More people now have health insurance, but about 12 percent of adults aged 18 to 64 remain uninsured. One thing, however, is certain: The existence of a federal law mandating that people buy something shows how unusual the market for health care is.

The best way to navigate the problems of the health care marketplace is hotly debated. The political left wants a stronger government role, and the political right wants regulation to be less heavy-handed. But policy wonks of all stripes can agree that health policy is, and will always be, complicated.

N. Gregory Mankiw is the Robert M. Beren professor of economics at Harvard University.
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ccp
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« Reply #1623 on: August 14, 2017, 04:05:56 PM »

Only legal to sell to those over 21 yo.



http://www.nationalreview.com/article/450444/food-drug-administration-commissioner-scott-gottlieb-changes-united-states-tobacco-e-cigarette-policy
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DougMacG
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« Reply #1624 on: August 15, 2017, 10:18:02 AM »



Pulitzer Prize winning editorial writer, died at age 34, July 2017

Joe Rago continued:

The Political John Roberts
The Chief Justice again rewrites ObamaCare in order to save it.

June 25, 2015

For the second time in three years, Chief Justice John Roberts has rewritten the Affordable Care Act in order to save it. Beyond its implications for health care, the Court’s 6-3 ruling in King v. Burwell is a landmark that betrays the Chief’s vow to be “an umpire,” not a legislator in robes. He stands revealed as a most political Justice.

The black-letter language of ObamaCare limits insurance subsidies to “an Exchange established by the State.” But the Democrats who wrote the bill in 2010 never imagined that 36 states would refuse to participate. So the White House through the IRS wrote a regulation that also opened the subsidy spigots to exchanges established by the federal government.

***
Chief Justice Roberts has now become a co-conspirator in this executive law-making. With the verve of a legislator, he has effectively amended the statute to read “established by the State—or by the way the Federal Government.” His opinion—joined by the four liberal Justices and Anthony Kennedy —is all the more startling because it goes beyond normal deference to regulators.

Chief Justice Roberts concedes that the challengers’ arguments “about the plain meaning” of the law “are strong.” But then he writes that Congress in its 2010 haste bypassed “the traditional legislative process” and thus “the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.” So because ObamaCare is a bad law, the Court must interpret it differently from other laws.

Opinion Journal: Roberts Saves ObamaCare Again
Editorial Board Member Joe Rago on the Supreme Court decision to uphold ObamaCare subsidies to federal health exchanges in King v. Burwell.

More to the political point, the Chief argues that withdrawing the subsidies would undermine larger ObamaCare goals such as giving “certain people tax credits to make insurance more affordable” and could lead to bad policy consequences like higher costs. “It is implausible that Congress meant the Act to operate in this manner,” he writes.

Even Solicitor General Donald Verrilli didn’t try to convince the Justices to rule in favor of the good intentions of “reforming” one-sixth of the economy. Instead he stressed statutory ambiguity and asked the Court to defer to the IRS. But Chief Justice Roberts goes beyond this and simply substitutes his own version of what he thinks Congress intended. This means that not even a new President with a new IRS could rewrite the subsidy rule because this rule is now what Chief Justice Roberts says it is.

As Justice Antonin Scalia observes in his coruscating dissent, “We [the Court] lack the prerogative to repair laws that do not work out in practice, just as the people lack the ability to throw us out of office if they dislike the solutions we concoct.” (See more Scalia nearby.) The framers made the judiciary the least accountable branch and vested all legislative power in Congress to protect the accountability necessary for durable self-government.

Justice Scalia quips acidly that “we should start calling this law SCOTUScare,” but the better term is RobertsCare. By volunteering as Nancy Pelosi’s copy editor, he is making her infamous line about passing the law to find out what’s in it even more true than she knew at the time. 
« Last Edit: August 15, 2017, 10:21:00 AM by DougMacG » Logged
DougMacG
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« Reply #1625 on: August 15, 2017, 10:24:44 AM »

Beware the Obamacare industrial complex
Its litany of lies are resurfacing, and consumers will pay the price

http://m.washingtontimes.com/news/2017/aug/13/obamacare-lies-resurfacing/

By Stephen Moore -
Sunday, August 13, 2017
ANALYSIS/OPINION:

The danger of a Republican bailout of Obamacare is mounting with every passing day. A group of “moderate” Republicans calling themselves the Problem Solvers Caucus is quietly negotiating with Democratic leaders Nancy Pelosi and Chuck Schumer to throw a multi-billion dollar life line to the Obamacare insurance exchanges.

This bailout, of course, would be an epic betrayal by a Republican Party which has promised to repeal and replace the financially crumbling Obama health law.
 
Republicans who are “negotiating” this bipartisan deal, such as Sen. Lamar Alexander of Tennessee, object to the term “bailout” for this rescue package. The left prefers the euphemism “stabilizing the insurance market.” The Washington Post’s left-wing fact checker, who just can’t seem to get his facts straight, says “bailout” is misleading pejorative language. The Post claims this is merely a payment to low income families to help pay for the escalating premiums under Obamacare. These payments were allegedly always part of the law as passed.

The hypocrisy here is towering. These are the same people who told us over and over again that Obamacare was going to “bend the cost curve of health care down.” These are the same people who promised that Obamacare was going to “save” the average family $2,500 a year in lower insurance premiums. (If Obamacare were lowering insurance costs not raising them, there would be no need for these bailout funds in the first place.)

These were also the same people who swore to us that Obamacare wasn’t going to raise the federal deficit by a dime. Oh really. Where is the $10 to $20 billion to pay for this new federal subsidy going to come from? Pixie dust?

Incidentally, is there even one single promise of Obamacare that has been kept after seven years?

So why is everyone suddenly rallying for an Obamacare bailout? Why aren’t they demanding more consumer choice, an end to the odious individual mandate, repeal of the tax increase, and expanded health savings accounts? The answer is simple. The new health law has given rise to an Obamacare industrial complex. The health system is now like a cocaine junkie hooked on federal payments.


This addiction explains why the insurance companies are lobbying furiously for these funds alongside their new found friends at left-wing interest groups like Center for American Progress. The irony of this alliance is that the left-wing allies the insurers have united with hate insurance companies and want to abolish them. The insurance lobby is selling rope to their hangman.

Hospital groups, the American Medical Association, the AARP and groups like them are on board too. They are joined by the Catholic Bishops and groups like the American Heart Association and the American Lung Association. (If you are donating money to any of these groups you might want to think again.) This multi-billion dollar health industrial complex has only one solution to every Obamacare crack-up: more regulation and more tax dollars.

For example, the Obamacare industrial complex argues that there was an innocent mistake in the Obamacare law as written (imagine that, maybe next time they will read the bill before they vote on it) and that these bail-out funds to Obamacare were intended to be automatic entitlement payments that would not have to be appropriated by Congress.

The Obamacare lobby is salivating over that idea. Every year the insurance companies would get fatter and fatter checks from the government no matter how much Obamacare costs escalate. Is this what the “Problem Solvers” in Congress really want? Financial accountability would be thrown out the window and Obamacare would become an appendage of Medicaid with exploding costs and a blank check from taxpayers.

This year the best estimate is that Obamacare will need at least $10 billion more to keep the system solvent. The death spiral in the program is getting more dire with every passing month, so it’s highly predictable these costs will ratchet up to $20 billion next year and more in the years that follow.

You can call this a bailout or just a swindle of taxpayers who were fed a litany of lies about Obamacare’s virtues from the very start. Either way taxpayers get shafted (again) and the Obamacare industrial complex gets fat and happy. If Republicans are partners to this fiscal crime, they are as culpable as the Democrats who passed this turkey in the first place and they certainly don’t deserve to be the governing party.

• Stephen Moore is a senior fellow at The Heritage Foundation and an economic consultant with Freedom Works.
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ccp
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« Reply #1626 on: August 15, 2017, 10:40:13 AM »

ie: government control over all of out countries healthcare  and eventually expanded to the world government:

https://www.healthcare-now.org/blog/obama-for-single-payer-before-he-was-against-it/

Obama care was never expected to succeed.  It was *always* one step closer to the end game for the progressives.

Moore is all correct :

" the irony of this alliance is that the left-wing allies the insurers have united with hate insurance companies and want to abolish them. The insurance lobby is selling rope to their hangman."

absolutely - cash in while they can.  They know the game.
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ccp
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« Reply #1627 on: August 21, 2017, 08:59:10 AM »

A lot is still speculative.
yet we are being led to believe that anyone who had a concussion is destined to turn out like Glen Campbell:

http://www.amjmed.com/article/S0002-9343(17)30482-5/fulltext

we see lots of football player working as sport analysts who don't seem punch drunk...  but I digress

Interesting the author puts this in the body of the article:

" In Lithuania, where litigation after an accident does not exist, studies have revealed that the incidence of post-concussion symptoms 3 months after a concussion is no different than in a sex- and age-matched control group that did not suffer a head injury."

Not to downplay head inruies in sports but .........
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DougMacG
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« Reply #1628 on: August 21, 2017, 11:26:42 AM »

I would love to see Denny S get more involved on more of our threads here.  I recall a collection posted at GilderTech called Denny's Pearls that is worthy of its own thread.

In this piece dated April 2, 2017 he lays out some factors I had not thought of and articulates  other ones better than I have seen previously.  It is very difficult to put the magic of the free market to words; only a few people have been able to do it.  Mostly we just see the damage done by its absence.  I hope it is okay that I post this...  I would like to also put this in Economics - Science thread as the principles in play are not unique to healthcare.

A different article recently pointed out that healthcare inflation should be compared with our service economy, not goods, but still the question remains, why does an aspirin cost $10 apiece or a hospital room thousands per day while the price of computer power and so many other things keeps falling?  We are treating more afflictions with more new treatments all the time but why are no cost saving innovations being made to older, established  treatments?  Something is wrong and missing because of our tampering, skewing and destroying of the free market.
--------------------------------------
How (Healthcare) Markets Work, by Denny Schlesinger

http://softwaretimes.com/files/how+healthcare+markets+wor.html

At a forum I frequent I was challenged to explain why a universal healthcare system is more expensive and less efficient than a free market one. The challenge was posed by an anesthesiologist at a small town clinic.

What if I could convince you that universal health care made economic sense...that if might actually save you/us money?

Adam Smith knew that markets worked but he didn't know how or why so he invented the "invisible hand" to account for it. In the 240 years since The Wealth of Nations we have learned about the workings of markets. The things that we discovered include that markets are complex systems meaning they are not predictable in detail but we do know the kinds of effect that inputs have on prices and availability of goods and services.

What do you think happens when someone without insurance (or the ability to pay out of pocket) gets appendicits? Do you think they just stay home and die?

Think again. They come into the hospital, get taken care of, and then they don't or can't pay their bill. The hospital and staff "eats" the expense. Next time you look at your hospital bill and see the $10 charge for aspirin, you'll understand why. The hospital needs to meet their expenses.
In other words, you are already paying for their care through your higher insurance rates needed to cover those who didn't pay.
Now think about it: if no one had to avoid getting care because of money, they would get their health problems taken care of early, and at less expense. I promise you, waiting until things are unavoidable (like not getting your blood pressure treated until you show up with a stroke) is vastly more expensive than pre-emptive care.

Your example is just one data point -- anecdotal to boot because you don't know the costs involved -- insufficient to come to a definitive conclusion. It also contains a conjecture (bolded by me) that I will show to be false.


Rotating governor used with steam enginesSystems are governed (controlled, moderated, regulated) by feedback, positive and negative. The easiest to understand "negative feedback" mechanism is the rotating governor

The faster spin pushes the weights outward and slower spin lets them drop. This movement is used to control the fuel supply keeping the machine at a constant speed.

An easy to understand "positive feedback" is the screeching of audio systems when the mike is placed too close to the speakers. The mike picks up the increasing volume feeding it right back into the amplifier and out the speakers.

Every input to the market is either positive or negative feedback. If I don't buy something today that's negative feedback, please lower the price if you want me to buy. If the government gives a subsidy that's positive feedback designed to amplify production. Once you think in terms of feedback you understand how the invisible hand works. This is how the law of supply and demand works. The law of supply and demand is the market governor.

What seems miraculous about supply and demand is how millions of independent transactions filter through the system to set prices. I doubt anyone has yet been able to model how that happens, but it happens in every free (independent transactions) market system. The end result is the optimum distribution of scarce goods and services from a cost point of view. The problem is that this distribution might not be socially acceptable and society will insert new feedback to change the shape of the distribution. No matter how noble the intentions, the end result is a less cost effective market.

In an unregulated market the feedback comes from millions of independent transactions. Add extraneous feedback and the economic efficiency drops. I've been pondering for years why the American healthcare system is so expensive. Blaming it on price gougers is not a good answer even if it is part of the answer. One has to dig deeper, search for the causal feedback gone amok. My observations lead me to believe that paternalistic employers were at least part of the problem (see link below). By improving their worker's lot they changed the feedback entering the market creating unexpected distortions one of which was to reduce the efficiency of the market, in other words, by making stuff more affordable for their own workers they shifted the burden to the rest of the market participants.

My first employer, IBM, gave me free healthcare insurance. I didn't have to worry or even think about healthcare costs. My bit of negative feedback disappeared! I want the best, let the free insurance deal with it. With changes in the economy and in the labor market, paternalistic packages (except for higher management) became too expensive. By this time, since the cost of healthcare was basically unknown, the visible culprit of high healthcare costs was the insurance industry. In fact, the healthcare insurance industry itself had been derailed. The purpose of any insurance is to protect wealth. Fire insurance can't protect a home from fire, it can only protect the owner from the cost caused by the fire. Healthcare insurance originally was designed to protect against the cost of unexpected medical care under the assumption that the ordinary health maintenance costs were to be included in the ordinary household budget like rent and other services. Unfortunately the insurance coverage morphed from the transfer of risk of high cost medical treatment to prepaid medical care. That is clearly not the purpose of insurance but it sure makes premiums go up and is highly profitable for insurance companies. But is also alters the feedback the market receives as the payer is not the patient but the insurer.

One easy remedy for the broken healthcare insurance industry is high deductibles which cause the patients to inject feedback into the healthcare industry, feedback that has been sorely lacking for years. Everybody should be a payer!

...  (more at the link)

Now let's put it all together: Insurance morphs into prepaid healthcare, angiograms go from when-needed to standard of care. More business for doctors, more business for hospitals, more business for the pharma industry, more business for insurance companies and, from what I have read, there is no payback in extended lifespans. On the other hand, if the standard of care procedure is not done, it's a good reason for a malpractice suit. This is what happens when your health is not in your hands but in the hands of experts.

Here again high deductibles are your friend, they force you to make a better evaluation of your situation, they give you back control over your health, over your body.

In general terms, market regulation is negative feedback designed to even out the playing field while incentives and subsidies are positive feedback. A free market advocate should accept a minimum of necessary regulation and the least amount of incentives and subsidies. The government has enough venues to provide incentives and subsidies such as the Manhattan Project, DARPA's Internet, the Interstate Highway System, and the Moon landing project to keep industry on the leading edge. The rest should be left to the free market.
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G M
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« Reply #1629 on: August 23, 2017, 09:31:50 PM »

https://www.firstthings.com/web-exclusives/2017/08/its-a-culture-war-stupid

IT'S A CULTURE WAR, STUPID
by George Weigel
8 . 22 . 17
Those who persist in denying that the Church is engaged in a culture war, the combatants in which are aptly called the “culture of life” and the “culture of death,” might ponder this June blog post by my summer pastor in rural Québec, Father Tim Moyle:


Tonight I am preparing to celebrate a funeral for someone (let’s call him “H” to protect his privacy) who, while suffering from cancer, was admitted to hospital with an unrelated problem, a bladder infection. H’s family had him admitted to the hospital earlier in the week under the assumption that the doctors there would treat the infection and then he would be able to return home. To their shock and horror, they discovered that the attending physician had indeed made the decision NOT to treat the infection. When they demanded that he change his course of (in)action, he refused, stating that it would be better if H died of this infection now rather than let cancer take its course and kill him later. Despite their demands and pleadings, the doctor would not budge from his decision. In fact he deliberately hastened H’s end by ordering large amounts of morphine “to control pain” which resulted in his losing consciousness as his lungs filled up with fluid. In less than 24 hours, H was dead.
Let me tell you a bit about H. He was 63 years old. He leaves behind a wife and two daughters who are both currently working in universities toward their undergraduate degrees. We are not talking here about someone who was advanced in years and rapidly failing due to the exigencies of old age. We are talking about a man who was undergoing chemotherapy and radiation treatments. We are talking about a man who still held onto hope that perhaps he might defy the odds long enough to see his daughters graduate. Evidently and tragically, in the eyes of the physician tasked with providing the care needed to beat back the infection, that hope was not worth pursuing.
Again, let me make this point abundantly clear: It was the express desire of both the patient and his spouse that the doctor treat the infection. This wish was ignored.

Canada’s vulnerability to the culture of death is exacerbated by Canada’s single-payer, i.e. state-funded and state-run, health care system. And the brutal fact is that it's more “cost-effective” to euthanize patients than to treat secondary conditions that could turn lethal (like H’s infection) or to provide palliative end-of-life care. Last year, when I asked a leading Canadian Catholic opponent of euthanasia why a rich country like the “True North strong and free” couldn’t provide palliative end-of-life care for all those with terminal illnesses, relieving the fear of agonized and protracted dying that’s one incentive for euthanasia, he told me that only 30 percent of Canadians had access to such care. When I asked why the heck that was the case, he replied that, despite assurances from governments both conservative and liberal that they’d address this shameful situation, the financial calculus had always won out—from a utilitarian point of view, euthanizing H and others like him was the sounder public policy.

But in Canada, a mature democracy, that utilitarian calculus among government bean-counters wouldn’t survive for long if a similar, cold calculus were not at work in the souls of too many citizens. And that is one reason why the Church must engage the culture war, not only in Canada but in the United States and throughout the West: to warm chilled souls and rebuild a civil society committed to human dignity.

Then there is the civic reason. To reduce a human being to an object whose value is measured by “utility” is to destroy one of the building blocks of the democratic order—the moral truth that the American Declaration of Independence calls the “inalienable” right to “life.” That right is “inalienable”—which means built-in, which means not a gift of the state—because it reflects something even more fundamental: the dignity of the human person.

When we lose sight of that, we are lost as a human community, and democracy is lost. So the culture war must be fought. And a Church that takes social justice seriously must fight it.


George Weigel is Distinguished Senior Fellow of Washington, D.C.’s Ethics and Public Policy Center, where he holds the William E. Simon Chair in Catholic Studies.
« Last Edit: August 26, 2017, 08:31:05 AM by Crafty_Dog » Logged
DougMacG
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« Reply #1630 on: August 29, 2017, 10:23:46 AM »

First, please read or re-read the previous post by G M in this thread.  Canada wouldn't treat a bladder infection because the guy was going to die anyway.  People (on the left or in a dream world) think we can remove money from healthcare by making it free but scarce resources get allocated one way or another.  The question isn't just right or wrong but WHO should make that decision.  If private citizens and their families make those choices with their own resources, the government would have more resources left to help when help is needed. !!!
----------------------------------------------------------------

One thing we should all agree on where government can play a role is to get healthcare pricing out in the open...  How can there ever be anything approaching a free market if we can't ever know prices?

http://www.realclearhealth.com/articles/2017/08/29/health_care_pricing_shouldnt_be_like_nuclear_codes_110717.html

Health Care Pricing Shouldn’t Be Like Nuclear Codes

By Greg Borca
August 29, 2017

Ask just about anyone what the most closely held secret is in America, and odds are they’ll either say the nation’s nuclear codes or the formula for Coca-Cola. Yet running a close third is the actual selling price of pretty much everything in health care.

The health care industry, especially the large players that dominate the landscape today, keep the actual dollars paid for care hidden amongst themselves, often obscured within complex contract language. Yes, there are “published” prices, but they bear little resemblance to the reimbursements providers and payers are agreeing to behind the curtain.


Consumers can see evidence of this moving target for pricing when they offer to pay cash directly to a provider versus going through a payer (aka an insurer) at the negotiated rate(s). The differences in pricing negotiated in contracts between providers and payers can be much greater.

The result of all this secrecy is that the per capita cost of something every single American needs has tripled over the last 20 years, rising to become nearly one-fifth of the gross domestic product. Yet no one seems to understand how to change this trend because if they did they’d be proposing a workable solution.

Worse, as long as there is a lack of financial transparency, it is impossible to take the steps that will create meaningful competition across the health care industry. Without competition, pricing will continue to rise needlessly, exacerbating all the issues that are being discussed in Congress right now.

Here’s why the lack of transparency around provider pricing is so effective at killing competition: When payers enter into negotiations with providers, their biggest bargaining chip is the number of members they can drive to that provider. So if health payer A has 3 million members in the market and health payer B has 1 million members, health payer A may get a contract that includes a much greater reduction off the published prices than health payer B.

Health payer A can then elect to offer slightly lower premiums than health payer B. Since the most important consideration for many consumers in selecting a health plan is their premium cost, health payer A gains a distinct market advantage. Add in a few high-deductible health plan (HDHP) options that shift more of the cost to the patient, and health payer A can gain even more market share.

This system of unknown selling prices is also why passing a law that enables insurers to sell across state lines won’t matter. When an insurance company enters a new market, it must negotiate pricing with local providers. The pricing it is offered is normally based on how many members it can direct to a provider. Since it starts out with zero members, it will pay much higher prices than the established insurers. The result will be higher premium costs. It then becomes a chicken-egg scenario. To secure competitive pricing the insurer must secure a large number of members. It cannot secure a large number of members, however, until it lowers its premiums. The new player is, in effect, locked out of the market.

What’s interesting is that health payers and providers didn’t always work together in such lockstep. Twenty-five years ago, the relationship was much more contentious. It wasn’t uncommon to read news stories about hospital systems that failed to reach an agreement with a particular payer and was thus terminating its contract and dropping out of the network. That is unheard of in this day and age.

It is also why those few startups that do manage to get off of the ground tend to rely on inventive strategies, such as narrow networks for high-cost procedures and broader networks for primary care. This two-tier approach is unorthodox but provides smaller insurers a way to find a foothold in larger markets.

If Congress really wants to bring down the cost of health insurance and spur competition, the solution is obvious: Level the playing field by requiring the health care industry to publish prices and costs and adhere strictly to those benchmarks. If an individual organization offers a discount to any player (including the federal Centers for Medicare & Medicaid Services), that now becomes the new price for everyone.

The creation of this type of price transparency will offer several consumer benefits. With pricing leveled and readily available for review, no single payer will have a huge, hidden cost advantage over the current competition.  An equal baseline for pricing will encourage payers to improve efficiency and reduce costs, and increased competition will furthermore help keep premium costs in check.

Level pricing will enable new, more efficient payers to develop, allowing for easier access to health care markets in other states.

Enabling such price transparency will allow consumers to shop for the best combination of quality and affordability; think Travelocity or Progressive, but for the best deal on health care in your area. This will be especially helpful as bundled payments and other value-based care options grow in popularity. Right now, if you call a provider and ask how much knee replacement surgery will cost, they won’t be able to give you a fast answer because it will depend on which insurance you have and which plan you’re on. With set pricing, you’ll be able to look it up online and compare.

Where final pricing is conditional on factors such as the state of the patient’s health, transparent pricing will make it easier for payers to deliver an instant explanation of benefits that will show patients exactly what their costs will be rather than being shocked by the costs months after the appointment or procedure. As more consumers adopt HDHPs, knowing those costs will be invaluable to both the patients and the providers who need to collect from them.

Perhaps the most important benefit, however, will be the freshly invigorated spirit of entrepreneurship that will drive down costs through innovative technologies and health care models we haven’t even imagined yet.

Think about how much cheaper air travel became after deregulation, thanks in large part to Southwest Airlines. Once Southwest started offering direct flights to destinations all over the United States for $39, every other airline had to slash its prices or perish. Consider what car buying is like now that automobile manufacturers publish their prices on the Internet for all to see.

Most of the current health payers are still using legacy green screen computing technologies from the 1980s. Why? Because they can. Startups entering the market using technologies designed for the digital age will create a need to modernize the established payers’ technology systems and processes so they can drive down their internal costs to compete with the startups’ significantly lower premiums.

These competition-driven efficiencies will lead to more options in the health insurance marketplace for consumers at lower costs, finally making affordable health care for all a reality. Not by government edict, but by intelligently harnessing the forces of the free market, which should satisfy all political persuasions.

The current system is unsustainable, but it is fixable. It’s time to quit treating health care pricing like it’s the nuclear codes and instead make real prices transparent to all.
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G M
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« Reply #1631 on: August 29, 2017, 02:05:05 PM »

As I understand it, access to healthcare is either controlled by price, or by rationing.
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DougMacG
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« Reply #1632 on: August 29, 2017, 05:42:21 PM »

As I understand it, access to healthcare is either controlled by price, or by rationing.

Right.  But rationing is based on price too.  They call it free but that doesn't mean your access isn't based on costs and money.  "Free" healthcare has a money cost to the government, to the taxpayer.  The doctor has a cost.  The room has a cost.  The nurse, the equipment, the supplies, the parking lot, everything.  

Canada has a 270 day wait for basic orthopedic services.  47 weeks for Neurosurgery!!!  See link.  How do you know now what Neurosurgery services you might need in 47 weeks??!!
http://globalnews.ca/news/3084366/q-a-how-long-are-medical-wait-times-in-canada-by-province-and-procedure/

Medical wait times in Canada, measured in double digits of weeks, are getting worse, not better.  They are a feature, not a bug, of their system.  The queue allocates scarce resources - by denying them.  Canada could lower wait times and ease their rationing anytime they want to - by spending more money.  Hire more doctors, invest in more equipment, build more facilities, serve more patients.  But they don't - because of money.

Pittsburgh has more MRI machines than Canada.  http://healthcare-economist.com/2008/02/11/pittsburgh-has-more-mri-machines-than-canada/  The southwest suburbs of Minneapolis have more MRI machines than Canada. I could still get a picture taken today, by spending money.  Canada knows how to buy more machines and hire more doctors and doesn't.  Money IS the limiting factor.

I know this is all obvious to everyone here, but we need to successfully address the liberal argument that it is immoral to allocate something as important as healthcare based on money.  There is no way around it.  Healthcare costs money.  Money is even more of a limiting factor in socialistic systems because their economies produce fewer resources needed to pay for things like healthcare.  And as you pursue sameness / equality, you necessarily lower the quality for many or most to accomplish that.

Canada has the advantage of something we will never have, a large, innovative, neighbor country right across the border to go to if and when your own system fails.  

Tens of thousands of people come from 50 states and 140 countries every year to visit Rochester Minnesota, home of the Mayo Clinic.  The Boston Globe calls them "reluctant tourists". https://www.bostonglobe.com/lifestyle/travel/2015/06/27/rochester-thrives-destination-medical-center-for-reluctant-tourists-flocking-mayo-clinic/i9FTkn3KHbobH5hOo8sqUJ/story.html
No doubt they would rather be treated near home or be on a beach somewhere, but this is how they CHOOSE to spend their time and their money at this point in their lives.

Cost is only one factor in affordable healthcare.  The other factor in affordability is income/wealth.  Grow the economy stupid (paraphrasing Bill Clinton).  Grow economic liberties.  Grow incomes and accumulate wealth to pay for things that may come up that are important to you - like medical treatment.

What is the Canadian equivalent of the Mayo Clinic?   (crickets)  
Mayo has a travel/communications office in Canada:  http://www.mayoclinic.org/departments-centers/international/locations/mayo-clinic-offices/canada
How come Presidents Reagan, H W Bush, Saudi King Abdallah, Jordan King Hussein, Iraqi President Jalal Talabani and so many others all came to Mayo.  Hugo Chavez went to Cuba; how did that go?  None of those who can choose, choose Canada.  What would they do there, wait??

Using Canadian or liberal logic, maybe the city of Rochester, MN would make even more on their hotel and restaurant traffic if the wait times were 47 weeks...
https://www.fastcompany.com/3041355/the-65-billion-20-year-plan-to-transform-an-american-city
http://dailysignal.com/2010/02/09/the-canadian-patients%E2%80%99-remedy-for-health-care-go-to-america/
« Last Edit: August 30, 2017, 05:39:57 AM by Crafty_Dog » Logged
ccp
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« Reply #1633 on: August 29, 2017, 06:12:06 PM »

"   ens of thousands of people come from 50 states and 140 countries every year to visit Rochester Minnesota, home of the Mayo Clinic.  The Boston Globe calls them "reluctant tourists". https://www.bostonglobe.com/lifestyle/travel/2015/06/27/rochester-thrives-destination-medical-center-for-reluctant-tourists-flocking-mayo-clinic/i9FTkn3KHbobH5hOo8sqUJ/story.html   "

Boston must be exceptionally jealous of this with their NEJM , Mass Gen , Bringham Young etc..........

« Last Edit: August 30, 2017, 05:40:24 AM by Crafty_Dog » Logged
ccp
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« Reply #1634 on: September 12, 2017, 07:31:36 PM »

http://www.huffingtonpost.com/entry/bernie-sanders-single-payer_us_59b7faa7e4b031cc65cd0637?ncid=inblnkushpmg00000009
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G M
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« Reply #1635 on: September 12, 2017, 07:36:36 PM »


MOAR. FREE. SH*T!

I'm sure it will work out well.
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ccp
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« Reply #1636 on: September 12, 2017, 07:46:37 PM »

" MOAR. FREE. SH*T!  "

Absolutely FREEEE !!!

who would not love this idea?Huh
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DougMacG
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« Reply #1637 on: September 13, 2017, 11:26:27 AM »

" MOAR. FREE. SH*T!  "
Absolutely FREEEE !!!
who would not love this idea?Huh

This is a defining moment; let's seize it.  Republicans failed to repeal ACA, for one reason, because of the uncertainty about what to replace it with.  Obamacare has clearly failed; no one argues that.  The 'honest liberal' answer is 'single payer', meaning make all healthcare a government program.  This is a serious proposal.  Bernie represents the left, the socialist and activist wing of the party and more than half of today's Democrats.  Al Franken has joined him.
 http://m.startribune.com/senators-seek-bipartisan-fix-to-avoid-premium-hikes-under-affordable-care-act/444064943/
https://www.realclearpolitics.com/articles/2017/09/12/democrats_split_on_sanders_medicare_for_all_plan.html

Pure, unadulterated socialism is on the table.  Good.  Let's bring it up, debate it and vote on it.  Let's get Democrats on the record for either supporting socialism or rejecting it.  And let's get some clarity among Republicans on the point of why not. Let's defeat the idea out in the open for young voters and all the other groups to see, that socialism has the answers when it never has.  See Venezuela.

More than a quarter of Senate Democrats, including several thought to already be laying the groundwork for 2020 presidential bids, have signed on to co-sponsor the single-payer legislation...
The vast majority of Democratic senators up for re-election next year have also shied away from backing Sanders’ bill. Only Tammy Baldwin of Wisconsin has signed on, endorsing the plan Tuesday and featuring the news on her campaign website. Republicans wasted no time going after her. “A $32 trillion socialist health care system is the last thing Wisconsinites want or need,” said National Republican Senatorial Committee Communications Director
https://www.realclearpolitics.com/articles/2017/09/12/democrats_split_on_sanders_medicare_for_all_plan.html
Good, let's split them, expose them and defeat them.

Free sh*t is first level thinking - like all liberal solutions.  Someone (like the President of the United States) needs to tell people why they shouldn't support it and convince them - free shit isn't free.  Socialism doesn't work.  Economic freedom outperforms big brother every time it's tried.  We should not give our most important, life saving industry over to the system known to perform the worst.
« Last Edit: September 13, 2017, 02:39:07 PM by DougMacG » Logged
ccp
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« Reply #1638 on: September 13, 2017, 06:02:56 PM »

"This is a defining moment; let's seize it."

Agree but do you really think Ryan or McConnell are going to do that?

I have ZERO faith in either
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DougMacG
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« Reply #1639 on: September 14, 2017, 09:38:58 AM »

...do you really think Ryan or McConnell are going to do that?
I have ZERO faith in either


I share the same frustration.  I don't take it to the level of hatred that Hannity and Levin seem to have. Didn't Reagan have an 11th commandment and these two commentators in particular worship Reagan.   These two are not leaders in this environment and I don't know if this congress is leadable.  Herding cats...  Ryan and McConnell aren't the problem; they just aren't the solution.

Reagan led by taking his case to the people and putting the pressure on the representatives from that direction.  McConnell for sure is not a take-it-to-the-people kind of leader and Ryan seems to have lost what got him there.  If not Trump, someone else needs to step up - on all these issues.  Maybe Pence needs to step in, put pressure on Murkowski in Alaska, Manchin in WV, etc.

The previous repeal failure was the fault of McCain, Murkowski and the ten Trump-state senate Democrats.  Maybe we needed a better bill and maybe this new one (Cassidy) is it.  Yet one Senator, Rand Paul, can kill this bill:  https://www.bloomberg.com/view/articles/2017-09-13/graham-cassidy-bill-is-the-latest-dim-hope-for-health-reform  http://thehill.com/policy/healthcare/350161-paul-new-obamacare-repeal-bill-probably-worse-than-nothing
That furthers smaller government how?

Problem is that they've muddled the bills and the principles and the messaging so badly that people even here don't know which bills we favor or oppose.

Again, zero Dem support even though ten of them serve in states Trump won, some in states Trump won by 30-40 points!  Who holds those feet to the fire?
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DougMacG
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« Reply #1640 on: September 19, 2017, 08:34:34 AM »

http://www.investors.com/politics/editorials/the-gops-last-ditch-effort-to-repeal-obamacare-is-surprisingly-good/

The GOP's Last-Ditch Effort To Repeal ObamaCare Is Surprisingly Good

Health Reform: After nine fruitless months, Republicans have finally come up with an ObamaCare replacement plan that is simple and appealing, and that should easily pass the Senate. Will the GOP blow it again?

Put together by Sens. Bill Cassidy and Lindsay Graham, the plan would take the money being spent on ObamaCare's insurance subsidies and Medicaid expansion, and give it to states in the form of fixed block grants.

States would then have wide latitude in how they spend the money — for example, they could use it to set up high-risk pools, reduce out-of-pocket costs, pay providers or subsidize premiums. They'd also be able to get out from under ObamaCare's disruptive and costly market regulations and benefit mandates.

It would repeal ObamaCare's individual and employer mandates, and its tax on medical devices. It would expand Health Savings Accounts and for the first time let those with accounts spend HSA money on insurance premiums. It would reform the rest of Medicaid by replacing the current open-ended matching grant program with fixed per-capita payments. And it would also let states impose work requirements for able-bodied adults enrolled in Medicaid.

Interestingly, while trying to craft legislation that would appeal to Republican moderates in the Senate, Cassidy and Graham have created a plan that is in some ways more conservative than the earlier House and Senate repeal-and-replace bills.

Those plans retained ObamaCare's disastrous "guaranteed issue" and "community rating" regulations and carried over its essential health benefits mandate, replacing one federal ObamaCare subsidy scheme for another. The plans were overly complicated and difficult to defend, but easy to attack.

The Cassidy-Graham bill, in contrast, is comparatively simple and straightforward. It lets states run their insurance markets as they see fit.

This is a welcome return to federalist principles that the GOP had forgotten when crafting their earlier ObamaCare replacement bills.

Is the Cassidy-Graham bill ideal? Of course not. Liberal states could keep ObamaCare in place, or use the money to finance single-payer health care. It concedes that the federal government is responsible for providing massive health care subsidies to the states. And it leaves many other free-market reforms off the table.

But look at the complaints from its critics, and you get a sense of why it's a step worth taking.

The liberal Center on Budget and Policy Priorities, for example, complains that "Cassidy-Graham would … allow states to spend their federal block grant on virtually any health care purpose, not just for health coverage." And states could "devise their own coverage programs."

The horror!

The other complaint from liberal groups is that Cassidy-Graham won't spend as much on health care as ObamaCare would. But if states can use their block money more effectively than ObamaCare, less will mean more.

Of course, the Congressional Budget Office will no doubt say that the bill will cause 20 million or so to "lose" coverage — a prediction that Republicans should ignore since, as we've pointed out in this space, it is based on outdated numbers and ridiculous assumptions.

To be sure, the chances of the Cassidy-Graham bill getting approved in the Senate are slim. The deadline for getting a repeal bill approved is September 30.

Two senators — Rand Paul and Susan Collins — have already come out against it, but John McCain says he'll back this. That means Alaskan Sen. Lisa Murkowski would have to change her previous "no" votes to "yes" if there's to be any hope of passage. (With a 52-seat majority in the Senate, the GOP can only afford to lose two GOP votes.)

Someone needs to remind Murkowski that she ran for election in 2016 repeatedly vowing to repeal ObamaCare. In May 2016, for example, she said on the Senate floor that "I have consistently supported full repeal of the ACA and have voted to do so on several occasions." But those votes, which took place while President Obama was sure to veto any repeal measure, were meaningless.

The question is, will Murkowski vote for repeal now, at the eleventh hour, when it will actually count? If she doesn't, Alaska's voters should replace her at their first opportunity.
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ccp
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« Reply #1641 on: September 19, 2017, 09:52:53 AM »

Thank God for McCain

What in tarnation is wrong with Rand Paul?

What good is "principals"  if we lose everything by him making some sort of false stand?

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Crafty_Dog
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« Reply #1642 on: September 20, 2017, 11:34:58 PM »



https://conservativetribune.com/sanders-invites-canadian-doctor/?utm_source=facebook&utm_medium=makeamericagreattoday&utm_campaign=can&utm_content=2017-09-18

 grin grin grin
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ccp
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« Reply #1643 on: September 22, 2017, 05:46:24 PM »

To think McCain was actually the GOP candidate back in '08! 

He is now the proud hero of the LEFT.

They will be awarding honorary degrees from Harvard and Columbia before he goes into the sunset in a blaze of glory in his own mind.

Joke on us folks.
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Crafty_Dog
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« Reply #1644 on: Today at 12:36:16 AM »

I was having similar thoughts myself today as well.

He would NOT have been a good president.
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