So time travel back to 2009.

 

Health costs are skyrocketing and employer provided insurance is starting to splinter. Looking at 1980 rates of employer coverage showed deep declines.

 

One prevailing thought was to bend the health care cost curve by making people have "skin in the game" (high deductibles). Make it more of a market where people felt need to choose generic medication since it wasn't all "Free".

 

It's possible this bent the cost curve, but it was stupid then and stupid now.

 

But hey , it has to be clear as day now that health insurance and health care are not a rational market. People intuitively cannot make cost decisions when health is at stake.

 

Making it more expensive for people was stupid. But they really, really need to just pool everyone together.

 

ACA can be dramatically improved with some state to state reinsurance smoothing but it isn't going to become dramatically better until there all 330 million are a single group, at least in some capacity.

He is the Mike Madigan of the GOP party. A real piece of s***.

 

That's not really fair. When has Mike Madigan ever not gotten his way? He may be a piece of s***, but he would have never gotten caught with his pants down like McConnell just did.

Hassan won NH by 1000 votes. That's really what the vote last night came down to. NH GOP has been busy pushing voter suppression efforts since the election.

So time travel back to 2009.

 

Health costs are skyrocketing and employer provided insurance is starting to splinter. Looking at 1980 rates of employer coverage showed deep declines.

 

One prevailing thought was to bend the health care cost curve by making people have "skin in the game" (high deductibles). Make it more of a market where people felt need to choose generic medication since it wasn't all "Free".

 

It's possible this bent the cost curve, but it was stupid then and stupid now.

 

But hey , it has to be clear as day now that health insurance and health care are not a rational market. People intuitively cannot make cost decisions when health is at stake.

 

Making it more expensive for people was stupid. But they really, really need to just pool everyone together.

 

ACA can be dramatically improved with some state to state reinsurance smoothing but it isn't going to become dramatically better until there all 330 million are a single group, at least in some capacity.

In the last several years the high deductible "consumer" plan has taken off coupled with an HSA. For some its cheaper than a PPO if you visit the doctor often or go through things like surgery or a birth. But its overall a sign of where the HC system is trying to go. And it's not positive IMO.

Now Americans also just straight up consume more healthcare in a way that doesn't improve health outcomes, so there is going to require some top down "no this isn't covered" in a way that will cause a lot of angst with whatever stronger system could be created.

HSA's are great as another tax-advantaged investment vehicle for higher income earners (you can basically treat is as an IRA once you hit retirement age and make withdrawals), not so great as health care policy.

 

I'm disappointed but not surprised to see the initial dem response this morning is as tepid as "public option in places with few insurers" rather than going all-in on Medicare-for-all or at least a national public option plan.

HSA's are great as another tax-advantaged investment vehicle for higher income earners (you can basically treat is as an IRA once you hit retirement age and make withdrawals), not so great as health care policy.

 

I'm disappointed but not surprised to see the initial dem response this morning is as tepid as "public option in places with few insurers" rather than going all-in on Medicare-for-all or at least a national public option plan.

 

To be 100% fair to them, they need to go big in 2018 campaigns, but now they honestly will need to create some leverage over a bipartisan fix in short term, because a lot of people are going to get screwed unless the exchanges get some support.

 

Basically compromise on killing medical device tax and get some funding for the exchanges. In that vein, seeing if a public option can be provided in absence of more than 2 providers in a state if the state elects would be very beneficial. ANd it wouldn't take effect fast enoguh that they couldn't go medicare for all in 2018.

 

They just kept their caucus together including Manchin throughout the whole process. Manchin didn't even give Snowe/Collins overtures.

 

Seeing McConnell fail should give people some more respect for Reid. If not for policy, that he could actually deliver. Schumer delivered in his first test.

The GOP has their chance for a legacy and perhaps pure domination for the next several elections. Just fix the ACA, make it single payer and make it work. You are then heroes.

60 percent want single payer, but we will NEVER get that.

 

I used to think this but I seriously think we will sooner than later. And people won't hate it as much as they think they will.

Every representative should be required to have a way for their constituents to vote online on every issue. And they should be required to comply. The only reason this system was put in place was to give representation to the folks who couldn't ride horses to the capital to vote. They shouldnt be able to act independently.

Every representative should be required to have a way for their constituents to vote online on every issue. And they should be required to comply. The only reason this system was put in place was to give representation to the folks who couldn't ride horses to the capital to vote. They shouldnt be able to act independently.

 

Not sure what that solves and i'm not sure why you would want that. A progressive agenda would take longer to implement as the people are generally years or decades behind on the various social issues.

Not sure what that solves and i'm not sure why you would want that. A progressive agenda would take longer to implement as the people are generally years or decades behind on the various social issues.

Because i fully believe that the people should be represented fully. Right now they arent, at all.

I woke up this morning, took in some sunshine, and was proud to be an American.

 

Good job to those three Republican dissenters.

I think California is the answer to "Should we implement direct democracy?"

^^

 

We need a more representative democracy than we have (wish list: abolish gerrymandering, the Senate, electoral college; expand HoR to keep representative:constitutents ratio even; switch from FTPT elections to something else e.g. proportional representation), but direct democracy isn't the solution imo.

McCain's statement in which he explains that he voted no because "skinny repeal" didn't go far enough in killing the ACA

 

"I don't mind Obamacare but I don't want to lose voters."

That's politics.

Well well well. Another old Trump tweet.

 

 

Donald J. Trump‏Verified account

@realDonaldTrump

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Obama's complaints about Republicans stopping his agenda are BS since he had full control for two years. He can never take responsibility.

Well well well. Another old Trump tweet.

 

 

Donald J. Trump‏Verified account

@realDonaldTrump

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Obama's complaints about Republicans stopping his agenda are BS since he had full control for two years. He can never take responsibility.

 

 

Three years to the day

 

 

Donald J. Trump ✔ @realDonaldTrump

So many major problems for the U.S., and no answers by our leaders. When will it all change? Many of our difficulties are so easy to solve!

8:00 AM - Jul 28, 2014

143 143 Retweets 196 196 likes

Those are some juicy Trump nuggets.

You can all eat crow.

 

Thank you Senator John McCain.

Eating crow. For now. Congrats.

I'm not super well versed on ACA because I have decent insurance through my job (though it increasingly costs more and more every year). But other than wanting to eradicate everything Obama did, I don't get the sentiment to repeal it.

 

Even if it's bad, and by some accounts that I read and respect, it is. I would think that it should be viewed just like any new business in its infancy. It's going to lose money. It will need to be adjusted.

 

Shouldn't the elected officials concentrate on improving what is in place? Obviously, some parts of it must work. How about tweaking it instead of blowing it up without anything to replace it?

"I don't mind Obamacare but I don't want to lose voters."

Exactly. But to be real. They could fix the ACA if they wanted. Just do it

"I don't mind Obamacare but I don't want to lose voters."

Exactly. But to be real. They could fix the ACA if they wanted. Just do it