Lion of the Blogosphere

Trumpcare is coming?

Based on the Washington Post exclusive, it sounds more and more like Trump plans to replace Obamacare with Trumpcare and not just repeal it, the latter being what Republicans have been bitterly trying to do (in protest) for the last several years.

It still remains to be seen if the final proposal matches the rhetoric. In the past, Trump would say one thing, then conservative hacks would say something else when they posted stuff on his campaign website.

If we do get a Trumpcare proposal, we will see that the vast majority of Republican voters, as well as most Republican legislators, hated Obamacare not because they hated expansion of government, but because they hated Obama.

On the other hand, if Democrats are united in opposition to Trumpcare, even though it has the same goals of Obamacare, because they hate Trump, and a few “principled” Republicans like Rand Paul vote against it, then Trumpcare could have problems getting through Congress.

Written by Lion of the Blogosphere

January 16, 2017 at 8:58 am

106 Responses

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  1. In the past, Trump would say one thing, then conservative hacks would say something else when they posted stuff on his campaign website.

    This has on the other hand worked to our advantage on immigration.

    snorlaxwp

    January 16, 2017 at 9:41 am

  2. Will Trumpcare penalize taxpayers without health insurance is a good question?

    JS

    January 16, 2017 at 9:56 am

    • How can you eliminate free riders without penalizing those without health insurance?

      David Pinsen

      January 16, 2017 at 7:48 pm

      • You handle free riders by only giving them access to the “public” hospital. A hospital which makes the experience uncomfortable enough that anyone who can manage it would never want to be treated there.

        Andrew E.

        January 16, 2017 at 10:17 pm

      • I guess that used to be the way it was before EMTALA as passed under Reagan.

        Lion of the Blogosphere

        January 16, 2017 at 11:32 pm

      • You can’t, unless the gov’t eliminates cash in its monetary system, and implement controls where all transactions have a trail.

        If you’re young and healthy, and without any unhealthy behaviors, you could get away with not having health insurance until middle age.

        But then again, America is not good for democracy, is it not? I know that every comment I make here seems to be of this nature.

        And given our current hostile climate, it would make sense not to be too invested with anything in America. Life in itself can be fleeting enough.

        JS

        January 16, 2017 at 11:51 pm

      • “If you’re young and healthy, and without any unhealthy behaviors, you could get away with not having health insurance until middle age.”

        JS, please confine yourself to pontificating about the parlous state of American culture.

        In my experience, being young includes pregnancy & childbirth. Risky business.

        gothamette

        January 17, 2017 at 11:59 am

      • I thought we voted for Trump for immigration and trade. Did he ever talk about “repealing” Obamacare during the election?

        gothamette

        January 17, 2017 at 6:21 pm

      • Yes he did.

        Lion of the Blogosphere

        January 17, 2017 at 7:24 pm

      • Gothamette — Everything we discuss here is about America’s graveyard state. Name anything positive…I know, we still have good food, so gorge while you can as the ship sinks.

        JS

        January 17, 2017 at 10:09 pm

  3. Holiday in mid-January? I hope Trump moves MLK Day to the first Monday in August.

    LOL. I love it. But he should wait until after that date passes in the last year of his administration; the lying media is going to blame Trump for all crime and terrorism occurring under him.

    Crime/terrorism reductions will also reflect badly on him, showing what a racist liar he is by saying crime/terrorism is a problem.

    snorlaxwp

    January 16, 2017 at 10:03 am

    • Any muslim terrorism will be used to implement Trump’s program. Likewise for hispanic crime. It might even be that BLM cop killings will no longer be taken to generate more sympathy for BLM. Trump won’t be moaning about the terrible backlash from whitey after his voters get killed by various human trash. The blame will go to the foot draggers.

      Glengarry

      January 16, 2017 at 12:39 pm

    • The holiday should have been on the anniversary of King’s famous speech on the mall in Washington, which did take place in the summer, and not as been as focused on King himself. I think the civil rights movement in general is an achievement worth having a federal holiday over, but putting it in January almost looks like an attempt to sabotage it.

      Just looking it up, the “I have a dream speech” was made on August 28th, so probably the holiday was put there because that is too close to Labor Day, but as it happens Labor Day is on the wrong date too. It should be May 1st. So move both. Or just get rid of “Labor Day” since this country has not been exactly friendly to the rights of Labor for some time now.

      Ed

      January 16, 2017 at 4:55 pm

      • The holiday should have been April 4. The civil rights movement was based on fabricated grievances.

        destructure

        January 16, 2017 at 10:07 pm

      • Here’s an example of one of the ‘infamous’ literacy tests that supposedly compelled enactment of the civil rights act. This one from Louisiana. My entire life I’d heard about these notorious tests given to both whites and blacks but somehow mostly an impairment to blacks (reasons not exactly spelled out in the breathless discussion of this incomprehensible evil). Perhaps not surprising, even today adults in Mississippi have the highest rate of low literacy in the nation, with 30 percent scoring as “Level 1” on the National Assessment of Adult Literacy conducted by the U.S. Department of Education in 2003. Level 1 literacy is generally defined as less than fifth-grade reading and comprehension skills. This 30 percent is not equally balanced between blacks and whites.

        Curle

        January 17, 2017 at 2:18 am

      • That is kind of terrible.

        What does “”draw a line around” mean? You have to box the answer in a rectangle? So if you underline or if your line looks curved to someone at the corners you fail I guess.

        Whats with the “first, first”? The first occurrence of the first letter of the alphabet? Then I think it should be “first first”.

        You are drawing three circle, one of which is inside another circle? Or is it circle inside another circle, which itself is inside the third circle?

        50% of this test doesnt seem to be testing literacy.

        Lion of the Turambar

        January 17, 2017 at 9:38 am

      • I agree that question 6 doesn’t tell you where the third circle is supposed to go.

        Lion of the Blogosphere

        January 17, 2017 at 11:06 am

      • I think literacy tests for voting would actually be a pretty swell idea if they were implemented fairly and had reasonable properties (like validity, reliability).

        The republicans should really think about a clever way to push something like this.

        alex2

        January 17, 2017 at 11:51 am

      • That literacy test tests literacy by asking people to perform simple tasks that even a child could do. Drawing a line around a number could be a square, rectangle, triangle, circle or trapezoid. A line is just a line, bruh. Ditto for nested circles. Don’t make it harder than it is. But here are the answers if you need to cheat.

        http://www.odonnellsclassroom.com/homework/PDF/Key%20for%20literacy%20test.pdf

        destructure

        January 17, 2017 at 1:52 pm

      • “fabricated grievances”

        Such as?

        gothamette

        January 17, 2017 at 6:27 pm

  4. Ryan certainly sounds like he’s still attached to and expects to pass some politically-disastrous libertarian healthcare plan.

    One thing the non-Trump GOP doesn’t do very well is nuance. Like they whipped up hatred of the individual mandate because that was the basis of their strongest legal theory in the SC case.

    But after the SC case failed they should’ve reintroduced an individual mandate into their O’care alternatives, as it had been in every GOP plan 1974-2010. It was totally nuts to continue the atavistic hate campaign towards mandates, because any healthcare plan that’s supposed to be both market-based and universal cannot work without mandates.

    Ideologue donor types of course love the false dilemma between O’care and libertarian granny-dies-on-the-street plans.

    snorlaxwp

    January 16, 2017 at 10:24 am

    • Who said anything about universal? No mandates, not ever.

      Andrew E.

      January 16, 2017 at 11:31 am

    • If memory serves, there has only been one Republican health care plan that featured a mandate. Besides, most Republicans regard the mandate, as used in Obamacare, to force you to purchase a private product, as unconstitutional, and they still think so in spite of John Roberts.

      This article really didn’t say anything new. Trump has said similar things during the campaign.

      Mike Street Station

      January 16, 2017 at 12:10 pm

      • Trump has got to twist the arm of the intelligence agencies so they tell him what they’ve got on Li’l Stinker Roberts. He has to be curious about it.

        Glengarry

        January 16, 2017 at 12:40 pm

      • Just because you hate Obamacare doesn’t mean it’s unconstitutional. Medicare is constitutional. Medicaid is constitutional. No legislation like ACA has been declared unconstitutional since the 1940s. Justice Roberts made the correct decision, in my opinion. His job is to interpret law and not be a hack for conservatives.

        People who don’t like Obamacare can vote the Democrats out of office, and they did just that.

        Lion of the Blogosphere

        January 16, 2017 at 3:31 pm

      • @Mike,

        Ryan is what I meant when used the undiplomatic phrase, “Midwestern rube” a few posts back. I didn’t mean to say that all Midwesterners were rubes. It was not very verbally graceful of me. Orson Welles was a Midwesterner, geez. From Kenosha.

        gothamette

        January 16, 2017 at 3:20 pm

      • “Just because you hate Obamacare doesn’t mean it’s unconstitutional. Medicare is constitutional. Medicaid is constitutional”

        Hate may be too strong a word. I think it was put together poorly and it shows. But Medicare and Medicaid is paid for by a combination of employer.employee tax and (mostly) general tax revenue. That totally different from making a general requirement to buy a private product. You may think the commerce clause was intended to allow that, but I don’t.

        Mike Street Station

        January 16, 2017 at 7:07 pm

      • Ryan certainly sounds like he’s still attached to and expects to pass some politically-disastrous libertarian healthcare plan.

        I agree with Ryan more on healthcare than Trump, though I don’t think doing more than tweaking Medicare is politically advisable.

        If we do get a Trumpcare proposal, we will see that the vast majority of Republican voters, as well as most Republican legislators, hated Obamacare not because they hated expansion of government, but because they hated Obama.

        And also because Obamacare has turned into the outgoing administration’s domestic equivalent of the Libya intervention.

        The Undiscovered Jew

        January 16, 2017 at 7:27 pm

      • This the failure of Lions formulation:

        “If we do get a Trumpcare proposal, we will see that the vast majority of Republican voters, as well as most Republican legislators, hated Obamacare not because they hated expansion of government, but because they hated Obama.”

        Its the unconstitutional expansion of the Commerce Clause to empower the government to do anything it wants. In September 2009 Nancy Pelosi claimed that the Commerce Clause gave Congress “virtually unlimited” powers- including the power to compel people to buy products they dont want or need. Validating the idea that the government has unlimited power is dangerous.

        The Obamacare includes the premise that even if you dont need the product, the government’s need for you to subsidize other people in the insurance pool trumps that.

        Further, Obamacare makes illegal the most sensible type of insurance for most people- catastrophic care policies. Coyote has written on the financial advantages many times. So only does the government force you to buy something you dont want, it prevents you from buying thing you do.

        There are many reasons for conservatives to hate Obamacare. This isnt a my team/our team thing.

        Lion of the Turambar

        January 17, 2017 at 9:58 am

      • Since the 1940s, the Supreme Court has indeed granted Congress the authority institute any regulatory or spending scheme that it wants, and ACA is no different in magnitude than Medicare.

        And there has for a long time been a tax deduction for buying health insurance, which is economically the same as a penalty for not buying health insurance.

        Also, Dems wanted to include a public option, and the same Reps that are complaining about being forced to by private insurance are the ones who killed the public option.

        Lion of the Blogosphere

        January 17, 2017 at 11:08 am

      • “… and ACA is no different in magnitude than Medicare.

        And there has for a long time been a tax deduction for buying health insurance, which is economically the same as a penalty for not buying health insurance.

        Also, Dems wanted to include a public option, and the same Reps that are complaining about being forced to by private insurance are the ones who killed the public option.”

        I hardly ever get a chance to say this Lion, but you are wrong on just about everything.

        Obamacare is qualitatively different from Medicare. If Congress had went with a Medicare for all scheme, it wouldn’t have been unconstitutional. It would have been opposed by Republicans, but not on constitutional grounds.

        The idea that NOT having a tax deduction is the same as having a penalty is just ridiculous. I can barely believe you wrote that.

        Republicans didn’t kill the public option. They had little to do with the legislation. What killed it was a CBO report that came out with extremely high cost estimates, which caused Senator Lieberman to vow to oppose the ACA if it had a public option. That killed it.

        Mike Street Station

        January 17, 2017 at 11:38 am

      • “Republicans didn’t kill the public option. They had little to do with the legislation. What killed it was a CBO report that came out with extremely high cost estimates, which caused Senator Lieberman to vow to oppose the ACA if it had a public option. That killed it.”

        This cannot be emphasized enough. Not a single Republican in either house of Congress voted for the ACA. And yet, being Cuckpublicans not only have they somehow allowed themselves to be blamed by the Democrats for its shortcomings for six years, they will forever own the inevitable disaster that is about to ensue with the repeal and replacement.

        Two in the Bush

        January 17, 2017 at 2:19 pm

      • ” If Congress had went with a Medicare for all scheme, it wouldn’t have been unconstitutional. It would have been opposed by Republicans, but not on constitutional grounds.”

        Mike – did you mean Medicaid?

        In any case I think that’s what’s coming down the pike. But how will the insurance companies take it? They have to get a cut, say, administer it in each state.

        gothamette

        January 17, 2017 at 6:40 pm

      • “Mike – did you mean Medicaid?”

        Well I meant Medicare, but I was only using it as an example. My guess is that Trumpcare will keep the Medicaid expansion however, or some version of it.

        Mike Street Station

        January 17, 2017 at 10:58 pm

  5. Repeal of ZeroCare should be smooth sailing because the Repubs are doing it via budget reconciliation, so they need simple majorities, and filibuster doesn’t apply. That’s how the Democrats shoved ZeroCare up our collective ass (like the sodomitic rapists they are) and that’s how ZeroCare will be surgically extracted.

    hard9bf

    January 16, 2017 at 11:12 am

  6. Oh, and I almost forgot to wish y’all:

    Happy Black Supremacy Day!

    hard9bf

    January 16, 2017 at 11:16 am

  7. I think this is just Trump saying whatever pops into his head. Trump thinks this is what his supporters want to hear, so he says it.

    Who is writing this plan? Tom Price, Trump’s pick to head health and human services, has been an outspoken opponent of Obamacare. Trump isn’t going to write the plan and I’m not sure he can find anyone in his administration that will.

    mikeca

    January 16, 2017 at 11:24 am

    • Is it? When he was preparing to run on the Reform Party ticket in 2000 Trump published a book called “The America We Deserve” that called for universal health care. I haven’t read it, but in the link below you can find a passage from it where Trump advocates for an “equivalent of the single payer plan that … provides freedom of choice.”

      This bullet-point summary of Trump’s platform in “America We Deserve” actually matches up very well with the Trump we know today.

      http://www.ontheissues.org/America_We_Deserve.htm

      Richard

      January 16, 2017 at 12:49 pm

      • Trumps proposals really don’t add up, big tax cuts, increased military spending, no cuts to Social Security or Medicare, universal health care. The budget number just don’t add up. Maybe Republicans will just forget all about the deficit and spend money like it is 2005 again.

        mikeca

        January 16, 2017 at 9:47 pm

      • I suspect his “tax cuts” will be marginal rate cuts, not an actual reduction in taxes.

        J1

        January 17, 2017 at 4:17 pm

  8. I’ve long thought, based on his rhetoric and past support for single-payer (this is a guy who talked about how the NHS worked “incredibly well” – in a Republican debate!) that he might just go with a “medicare for all” plan. The only question would be how to get it through a republican congress. But imagine if that’s the first thing he proposed – maybe he could get Bernie to sponsor it? – it would completely knock the wind out of the Dems sails…

    jimbo

    January 16, 2017 at 11:33 am

    • Expecting companies to pay for their workers health insurance puts American companies at a big disadvantage, and Trump and the other tycoons in the administration are well aware of that. They probably want to do something to remove that, and repealing the tax deduction for health care has been a favorite right-wing idea, but it would be weird just dumping millions of middle class Americans out of their health insurance at a time when life expectancy has fallen.

      So the logic points to removing corporate healthcare but putting in place some government program, but they you get the ideological objections, and the health insurance industry. One thing Sanders accomplished was to soften the ideological problem, at least with the general public. Trump will try to do a deal with the health insurance companies, but I don’t see how even he can get far. The approach has been tried in the past and things are the best they can be for them now.

      Ed

      January 16, 2017 at 5:04 pm

  9. Maybe OT, but what you think about this guy? Look at this blog: https://dissention.wordpress.com/

    (disclaimer: it is not my blog, I am just anonymous shitposter on the Internets)

    He is the ultimate nightmare of “alt right” – Asian Indian sex-obssesed white race hating anarcho-communist, but his analysis and predictions proved to be prescient.

    https://dissention.wordpress.com/2016/11/12/on-the-implosion-of-hillary-clintons-presidential-campaign-1/

    “I first wrote that Trump was likely to the republican presidential candidate on August 31, 2015. Infact, I wrote a whole series of posts on why Trump was likely to win the republican nomination at a time when most people saw his candidacy as a joke or an act of self promotion. And it only gets better from there because I also wrote (on February 20, 2016) that Hillary Clinton would lose the presidential election against an even moderately competent Republican opponent. I also predicted that many blacks who voted for Obama would not vote for Hillary Clinton, in a post of February 11, 2016. I also predicted that the HRC ‘private email server and deleted emails’ controversy would be exposed as an example of legal corruption in a post on January 21, 2016.”

    And now he predicts that Trump’s presidency will make GWB look like genius, and will finally send America, capitalism and white race to the dustbin of history.

    https://dissention.wordpress.com/2016/11/19/some-initial-thoughts-on-the-likely-trajectory-of-a-trump-presidency-1/
    https://dissention.wordpress.com/2016/11/26/some-initial-thoughts-on-the-likely-trajectory-of-a-trump-presidency-2/

    Is he blinded by his bias, or is he up to something?

    Darin

    January 16, 2017 at 1:01 pm

    • HIs blog looks pretty good, I may spend some time reading it.

      Lion of the Blogosphere

      January 16, 2017 at 3:34 pm

      • So that is what it’s like being hated like a Jew.

        Huh.

        map

        January 16, 2017 at 5:17 pm

      • don’t waste your time, I’ve read every his post several times, it’s deranged, incoherent nonsense. His single posts have internal consistency, not due to its content but thru simple rhetoric. He still believes that Trayvon was there to hug Zimmerman and such…..

        bombexpert

        January 16, 2017 at 5:24 pm

      • Obamacare is considered constitutional only by judicial fiat. The case began with the threshold question of standing, i.e., was this a challenge to a tax law passed by Congress. If it was (outside of an Establishment Clause challenge), then the issue was not justiciable. The Court ruled that the issue was justiciable and then ruled that the law was constitutional because it was a tax and not an exercise in Congress’ power to regulate commerce.

        Del Gue

        January 16, 2017 at 6:15 pm

      • The case was based on a stupid technicality that (1) it’s OK to raise everyone’s taxes and use the revenue to provide healthcare; (2) it’s OK to give someone a tax deduction for buying healthcare; (3) but somehow it’s unconstitutional to have a “penalty” for not buying insurance.

        This is stupid. If there’s a tax deduction, then it’s the economic equivalent of a penalty to anyone who doesn’t qualify for the deduction. Roberts understood this and to his credit was not a Republican hack.

        Lion of the Blogosphere

        January 16, 2017 at 6:20 pm

    • That blog is written by an idiot, if this quote is at all representative:

      “The reality is the USA does not have the financial capability, dominant influence, adequate number of soldiers, appropriate weapons, sufficient technological edge or industrial capability to actually win a war against any determined adversary- be that another competent nation-state or a popular non-nation entity in any part of the world.”

      yeah, sure. With even semi-competent and determined leadership the US can easily destroy ANY adversary that currently exists. Even China would be defeated easily in a few months. And every government in the world knows this. That’s why only terrorists, who don’t actually run any countries, and therefore have no return address the US can obliterate, dare to attack us directly.

      JimboHarambe

      January 16, 2017 at 4:28 pm

      • He talks about politically possible conventional war, of course US can use nukes and other WMD to wipe any country in the world.

        Darin

        January 17, 2017 at 2:56 pm

      • He’s wrong about all those things, but he leaves out the most important factor: the will. Without that, no amount of the other items will make any difference.

        J1

        January 17, 2017 at 5:02 pm

    • The blog Dissention reads like the ramblings of a man child. He imagines Bush43 to be the nadir of Western civilization and the power of aggrieved blacks to be determinative of Trump’s success or failure. Clearly, he does not understand that blacks, at least in the US, are always pawns for others. History is not this fellow’s strong suit.

      Curle

      January 16, 2017 at 5:31 pm

    • Not sure why people are reacting so negatively to him. Whatever he might have said elsewhere, in the linked postings his reasons for thinking that Trump’s presidency will be a failure seem pretty reasonable. Establishment Republicans *are* deeply opposed to Trump and Trump’s agenda, they already disowned him during the campaign and if his administration ever sails into a rough patch they’ll disown him again. In fact, they’ll phrase and time their denunciations in such a way as to do maximum damage. That’s new in modern American politics.

      He’s also right that GOPe leaders will try to foist their lame programs onto him and undercut any Trump effort to depart from establishment consensus, as Paul Ryan did just a few days ago when he declared tariffs were off the table, and right now Mike Lee is writing legislation in the Senate that would remove many of the president’s powers to enact trade policy independently.

      Trump is facing immense challenges, and he starts out underwater in the popular vote with little popularity to spare.

      Richard

      January 16, 2017 at 7:25 pm

      • Paul Ryan did just a few days ago when he declared tariffs were off the table

        Trump isn’t taking no for an answer, although I’m not sure he can get congressional majorities even with Democrats.

        https://www.google.com/#q=Trump+Warns+on+House+Republican+Tax+Plan

        snorlaxwp

        January 16, 2017 at 9:55 pm

      • The border adjustment that he’s attacking is actually a very good idea. I expect this is a negotiating tactic, however.

        snorlaxwp

        January 17, 2017 at 8:49 am

      • Trump has the power to destroy any congressman in any congressional seat, save the bluest of blue regions in New York and California. There are legions of Trump voters who still did not turn up in this election because they live in Red or Blue safe states. Trump has the power to destroy Paul Ryan or Mike Lee on a whim in 2018. He probably will do it anyway, but they still have a shot at begging for mercy. If they know their seat is on the line, they will tow the line. Remember, they have no useful skills outside of being politicians, so if their political careers end that year they won’t be able to continue living a comfortable upper middle class lifestyle. They know this. Lobbying is no longer an option as Trump will close those loop holes.

        This applies to virtually any congressman who doesn’t reside in a super solidly blue district (think 90%+ democrat).

        Trump could theoretically destroy Dem politicians to by endorsing them (hence giving the person he actually supports a talking/rallying point).

        Politics is no longer war by other means. Politics has become the war itself.

        OldTimer

        January 18, 2017 at 12:00 am

    • I’ve been reading more of his blog and finding it pretty impressive. Here’s a post from way back in 2012 on the lack of social cohesion among contemporary elites, which he links to the replacement of aristocracy, held together by marriage bonds between families, by the modern “meritocracy,” which is based on proving your worth by leapfrogging over someone else. This inability to organize helps explain why Trump was able to scatter them like stick figures against all “expert” predictions.

      https://dissention.wordpress.com/2012/10/11/effects-of-social-atomization-on-the-so-called-elites/

      Richard

      January 16, 2017 at 7:58 pm

      • Just read that post about elite atomization. He almost had a good point… until he buried it beneath a pile of BS. To summarize, he started out well enough by claiming the elite were screwed up. But he blew it explaining how and why they went off the rails. He believes the elite are atomized because they’re too busy competing to form a gentleman’s agreement and be the proper hedonists they should. Sounds like he’s been watching A Beautiful Mind i.e. “governing dynamics”. It’s not so much that his observations are wrong (they kind of are) but he’s mostly confusing correlation with causation. The reason Bezos, Buffett. Gates and Zuckerberg aren’t hedonists isn’t because of atomized competition, etc. It’s because they don’t want to be. The wants who want to are.

        destructure

        January 17, 2017 at 3:40 pm

      • They’re not “because they don’t want to be” isn’t very enlightening and sounds pretty Just So-ish. Competition among the post-aristocratic elite leads to atomized weirdos at the top because anyone who would want to stop for a moment and “smell the roses,” so to speak, gets leapfrogged over by somebody else and isn’t that elite anymore.

        What struck me about that post was its clear application to the 2016 election. Professional commentators all assumed that Trump had no chance because of “The Party Decides” theory; that when GOP elites saw that their position was threatened, they would organize against Trump and use their numbers and institutional clout to stamp him out. That never happened at an effectual level. The GOP primary race saw 17 candidates running, 16 fairly conventional candidates and Donald Trump. Trump took the polling lead six months before a single race was held, and if elites had any organizational will or intelligence they would have gotten most of those dozen-plus candidates to drop out so the vote they held could be coalesced early enough that Trump could be stopped. It was not a question of principle, because nearly all of these candidates had identical views on the major issues. What held them up was agony over status and personal grudges. Who would step down so another man could rise? So nobody stepped down until they were forced to by their electoral path closing, and some of them stuck on long after that out of what appears to be spite (Kasich).

        Under an aristocratic system these bickerings between Bush and Kasich and Rubio et al would have been settled with an arranged marriage or two.

        Richard

        January 18, 2017 at 1:37 am

  10. There should be no Trumpcare until the immigration is taken under control. He should focus on what’s most important. I doubt health care can be fixed in this country.

    Yakov

    January 16, 2017 at 1:01 pm

    • Why can’t they just do a system like Australia or Canada? In Australia you pay 1% of your salary for insurance. Beyond a certain salary bracket you have to pay 2% but you can put this second 1% into a private insurance so you get better treatment if you are rich. You can even pay more to get all kind of special private stuff. That means that everybody who works get a reasonable treatment, rich people get better treatment and non working people also get the basic treatment automatically without having to pay. All that without co payments, you just go in and get your treatment. Some doctors charge extra but there are enough clinics catering for the basic insurance. This is a very simple system and easy to implement, it doesn’t cost more than what people in the US pay, so what is the problem implementing something like that or similiar?

      Hashed

      January 16, 2017 at 3:48 pm

      • Because right now 45% of Americans pay no federal income tax, and for the last 50 years Americans have been conditioned to react with horror at the idea of anybody raising their taxes.

        Richard

        January 16, 2017 at 7:32 pm

      • Any national healthcare system which emerges in the United States in the present environment will wind up explicitly discriminating against whites in short order. Every other large system does.

        verylongaccountname

        January 16, 2017 at 8:16 pm

      • Richard, “Hashed” said 1% of your salary, not taxes. If people who don’t pay taxes don’t wanna pay 1% of their salary, tough shit.

        I think what you mean is that a lot of Americans are without income entirely. They would go on Medicaid.

        Hashed –

        It’s an excellent solution and the reason why we can’t institute it is that we are like a junkie who won’t give up his dope. It’s system.

        The US system just “growed”, like Topsy. It worked OK for a while, but when it didn’t work OK, we already had the entrenched interests of a powerful insurance industry to work against anything that they perceive would harm them.

        But the insurance industry isn’t the only reason. Congress is made up of hacks whose job is basically to squeeze as much pork from the pig as possible. No one goes to Congress with the national interest in mind. He’d be a fool if he did. So don’t look to the Congress for a solution.

        It’s the President’s job to wade into the mosh pit and create order from chaos. But Eisenhower was the last of the presidents with personal/moral authority, and old fashioned patriarchal dignity. JFK had none of that, and anyway, he was assassinated, and what came after him was a succession of failures and losers. The huge divide came with Clinton, who was a morally compromised catspaw of the Republicans. With him the last of the breaks on total corruption and cupidity was swept away. And now we have a wasteland, a ruin. Whoever is president has no power to speak on behalf of “The People.”

        And that’s my take on why we can’t do something as simple and functional as you’ve suggested.

        gothamette

        January 17, 2017 at 12:11 pm

      • Because costs have been rising 6-9% annually for 30 years. Precisely because people keep trying to fix the system.

        There is only one way for the system to be fixed. Have every healthcare provider post prices ahead of time before an procedures are done and prosecute with extreme prejudice the ones that try to rip you off because you were unconscious and couldn’t consent to a price (eg. you are unconscious and need a blood transfusion, this is not an excuse to jack up the price 10x above market like an uber surge pricing).

        Throw people in jail if you have to and market discipline will return quickly. It worked in the auto repair market.

        OldTimer

        January 18, 2017 at 12:04 am

      • 1%?

        That’s rich.

        But it won’t buy much more than a band-aid.

        In Germany, public health insurance costs 16 – 17% of your salary.

        Thin-Skinned Masta-Beta

        January 18, 2017 at 7:37 am

  11. most Republican legislators, hated Obamacare

    That may be true for many Republican voters, but Republican congresspersons overwhelmingly voted in favor of Obamacare (House 416-0, Senate 60-39 in favor). And republican president GWB’s appointment to the USSC, Chief Justice John Roberts, sided with the four liberal votes to uphold the provisions of Obamacare.

    E. Rekshun

    January 16, 2017 at 4:21 pm

    • ^but LotB is spot on – TrumpCare will not get through Congress no matter how wonderful because of spite; too Democrat congress persons hate President Elect Donald Trump.

      E. Rekshun

      January 16, 2017 at 4:24 pm

    • Not one single Republican member of the house voted for Obamacare. What are you talking about?

      https://www.healthreformvotes.org/congress/roll-call-votes/h165-111.2010

      CamelCaseRob

      January 16, 2017 at 8:15 pm

      • Ok, thanks. I misread my source.

        E. Rekshun

        January 17, 2017 at 1:39 am

  12. OT but over at Sailer, a commenter posted that Peter Brimelow founder of the anti-immigration site VDare, has a salary of $378k. This was answered by a guy who says he makes more than that as an air-conditioning repairman.

    marty

    January 16, 2017 at 4:28 pm

    • The guy is lying or else he means he is the *owner* of an HVAC repair company.

      CamelCaseRob

      January 16, 2017 at 8:10 pm

  13. What idiot gave or leaked an exclusive to the Washington Post? They are the enemy. You don’t feed the enemy.

    Curle

    January 16, 2017 at 5:16 pm

    • “What idiot gave or leaked an exclusive to the Washington Post?”

      Trump himself.

      Lion of the Blogosphere

      January 16, 2017 at 6:16 pm

    • What idiot gave or leaked an exclusive to the Washington Post? They are the enemy. You don’t feed the enemy.

      This is how politicians control the press. If the press wants exclusive news, then they have to say nice things about the president. Otherwise he will give the exclusive to some other news organization.

      mikeca

      January 17, 2017 at 11:38 am

  14. I know other writers have brought up the medical monopolies and other collusive practices in which medical companies engage. I agree with those writers and Karl Denninger’s criticisms.

    There is, however, a point of pride. I like the fact that the US has amassed such a huge and powerful medical industry and located it inside the United States. This is an incredible resource and it was created by design so that the US can fight wars on several fronts. This is also why the US excels at producing food and weapons.

    Outside of immigration’s effects on healthcare, the fact that so many developed and undeveloped countries get drugs, equipment and medical devices for a fraction of what American’s pay is a travesty. Our medical industries are a strategic resource. Therefore, any exports of said products should be sold by consignment through a US government entity. Said entity is required to get at least 90% of the American price for any medical products sold outside of the US. Any patent violations or attempt to re-engineer through generic compounders will be met with trade sanctions and a loss of access to said products. The government and Big Pharma can split the profits.

    This international free ride off of American taxpayers needs to end and the false outcome of foreign healthcare systems need to end as well.

    This should be a huge boost to government finances and the USG can use it’s cut of the profits to lower healthcare costs for Americans. We can then focus on dealing with medical monopolies directly.

    I am tired of hearing about how much cheaper everything else is in Europe and Canada when that cheapness is bought off the backs of Americans.

    map

    January 16, 2017 at 5:32 pm

    • So true. Excellent post.

      Heh, heh. Jim’s often good for some serious straight talk. This time on healthcare.

      http://blog.jim.com/economics/the-perils-of-government-intervention-in-health-care/

      Andrew E.

      January 16, 2017 at 6:34 pm

      • Read what this “Jim” guy writes about women ( TL;DR, he thinks ISIS are too soft on the woman question, and Boko Haram are just right). There is serious serial killer vibe i feel from him, I hope he is on some kind of watch list.

        Is he supposed to be some kind of anarcho-libertarian celebrity?

        Darin

        January 17, 2017 at 2:53 pm

      • I’ll agree with Jim re: women to the extent that for Western civilization to become naturally eugenic again instead of dysgenic, then the status of women in our society needs to be lowered significantly and the status of men raised significantly. And this must be enforced at the institutional as well as cultural level. Otherwise you get the runaway hypergamy, soft harems and low birthrates that characterize modern Western society.

        Andrew E.

        January 17, 2017 at 4:30 pm

    • That’s a good point. We’re subsidizing the drug costs of the world by paying market costs here at home.

      Mike Street Station

      January 16, 2017 at 7:18 pm

      • Kunstler is a bit of a loony, but he might be right about the entrenched oppo to Trump:

        http://kunstler.com/clusterfuck-nation/the-cheeto-cometh

        Nothing is going to happen on Inauguration Day. Kunstler has a bit of a fevered imagination. But I think the CIA has something up its slimy sleeve. Maybe Hillary is working with them to undermine Trump. Who knows?

        gothamette

        January 17, 2017 at 12:15 pm

      • I took a look at “The Jim Blog”:

        “The Daily Shoah are not my enemies, but my friends, and those who are their enemies, are my enemies. Whosoever goes after the Daily Shoah is likely to go after me.”

        Such readers you have, Lion.

        gothamette

        January 17, 2017 at 12:19 pm

      • Kunstler way overestimates CIA – when was the last time they managed a succesful assasination?

        Darin

        January 17, 2017 at 3:11 pm

      • “when was the last time?”

        Long time ago. But they bagged a big one, no?

        gothamette

        January 17, 2017 at 6:52 pm

    • Not a bad idea, actually. Though it might alternatively drive drug development out of the country so think of something to make them stay.

      Note that cheaper European care also comes from other sources, like doing fewer procedures, implementing rationing, having comparatively lower salaries for health care professionals at all levels, allowing less juicy legal options for disgruntled patients, and probably many other things.

      Glengarry

      January 17, 2017 at 11:50 am

  15. The only type of health care reform that makes even the remotest bit of sense is 100% socialized medicine, coupled with outcome-based rationing. Anything else is doomed to failure.

    Peter

    ironrailsironweights

    January 16, 2017 at 8:43 pm

    • Singapore has the most rational system I’m aware of. Also might be lowest cost among the developed nations, I’ve heard something like 2% of GDP. I doubt it would work well in the ghetto though.

      Glengarry

      January 17, 2017 at 11:52 am

  16. Our ideas of perfect…..are so imperfect.

    Johnson

    January 16, 2017 at 9:47 pm

  17. WaPo had a fake poll out today about Trump’s approval rating which they claim is only 40%. The highly regarded Otis Index, which was the most accurate polling aggregator of 2016 election, currently has Trump at 45.5%.

    Otis the Sweaty

    January 17, 2017 at 10:56 am

  18. “If we do get a Trumpcare proposal, we will see that the vast majority of Republican voters, as well as most Republican legislators, hated Obamacare not because they hated expansion of government, but because they hated Obama.”

    Liberals want big government because they want to redistribute wealth. And conservatives oppose big government because they don’t want to redistribute wealth. Conservatives don’t really mind government as long as it works and isn’t redistributing wealth. Also, conservatives don’t mind helping people in genuine need. It’s the transfer of wealth to people who don’t need it and didn’t earn it that aggravates them. Not so much the size of government. Conservatives wouldn’t mind universal healthcare if it wasn’t a wealth redistribution scam.

    This is frequently misunderstood because of the confusion that exists between conservativism and a certain type of libertarian who thinks they’re conservative. The confusion exists because they both oppose big government. But they oppose it for two different reasons.

    destructure

    January 17, 2017 at 1:21 pm

    • “conservatives oppose big government because they don’t want to redistribute wealth”

      That describes TruCons, but not necessarily Republican politicians (most of whom will take any position that helps get them re-elected), and especially not working class whites who voted most heavily for Trump, a group that was once solidly Democratic.

      Lion of the Blogosphere

      January 17, 2017 at 1:57 pm

      • You need to understand the difference between TruCons and real conservatives. I spent the last year arguing with people who were self-described “true conservatives” aka TruCons. TruCons are the fool’s gold of politics because they’re not what they claim to be. TruCons oppose big government because of “muh liberty” and “muh cunstitution”. They’re a strange kind of libertarian who opposes big government on the basis of liberty. Real conservatives like liberty and the constitution, too. But they’re not nutty about it like the TruCons. They don’t have a problem with big government as long as it works and doesn’t violate their values.

        destructure

        January 17, 2017 at 4:56 pm

      • “Liberals want big government because they want to redistribute wealth. And conservatives oppose big government because they don’t want to redistribute wealth”

        Hoo boy, there is so much wrong with these assumptions!

        Everybody wants to redistribute wealth, it just depends on what. Military spending is the biggest redistribution of wealth on earth.

        But I forgot. I’m dealing with a guy who still believes we were fighting Communism in SE Asia!!

        gothamette

        January 17, 2017 at 6:43 pm

      • “Everybody wants to redistribute wealth, it just depends on what. Military spending is the biggest redistribution of wealth on earth.”

        I don’t doubt that military contractors (or other special interests) would like to redistribute taxpayer money to themselves. But we were talking about universal healthcare and what voters think based on their values.

        “But I forgot. I’m dealing with a guy who still believes we were fighting Communism in SE Asia!!

        Yes. That would be the opinion of most mainstream historians.

        destructure

        January 17, 2017 at 11:13 pm

      • Realtalk:

        Conservatives oppose redistributing wealth because they (logically) oppose doing so to benefit those of differing racial groups. Redistributing wealth for your own group is called National Socialism, and its what most groups aspire to do when left to act freely. This is because it increases the numbers of the group in total, and works to preserve a minimum quality for its lowest tier members. Funding outgroups to outnumber you, and funding your political enemy to make their bottom tier more competent (sometimes works, often they are beyond rehabilitation) makes no sense.

        For ‘Truecons”, opposing redistribution is about the only racial tool that they have left to freely wield. Its sacrificing your bottom tier to avoid being overwhelmed by the more reproductively active bottom tier of the enemy.

        Frank

        January 19, 2017 at 6:20 pm

  19. @lotb
    ot
    re: basic income

    the Alaskan Permanent Fund Dividend?

    barton parker

    January 17, 2017 at 1:39 pm

  20. Realistically, it is very unclear what if anything is going to happen.

    There are several nuclear options under which Republicans can do whatever they want with Obamacare. They could abolish the filibuster with a majority vote or they could fired the Senate parliamentarian and replace him with someone willing to let Republicans make any changes to Obamacare they like through reconciliation. (Republicans did exactly that in 2001). Senate Republicans are not talking much about either of those right now and it is thought that there are some Republicans that are reluctant to do either of those options, but that could change.

    Without those nuclear options, Republicans can use reconciliation to get ride of the mandate and all the taxes that fund Obamacare, but leave the exchanges, subsidies and requirement to cover preexisting conditions in place. The CBO report released today predicts that would cause 18 million people to immediately lose insurance and cause insures to exit the non-employer health insurance market in most of the country. Without the mandate, health insurance companies don’t want to sell policies to everyone regardless of preexisting conditions. The policies would either be extremely expensive or insurance companies would simply exited the market.

    Republicans obviously don’t want that on their hands.

    Plans like Paul Ryan’s plan would require continuous insurance for the preexisting condition ban, but without one of the nuclear options, it is unlikely the Senate would be able to get to 60 votes to pass it. The Ryan plan by the way almost certainly has smaller subsidies that Obamacare. It includes high risk pools for people who did not have continuous insurance, but the funding is very small ($2.5 billion per year) and high risk pools are very expensive to operate so very few people could get into them.

    Unless Republicans are willing to use one of nuclear options, it is going to be very hard to repeal and replace Obamacare.

    mikeca

    January 17, 2017 at 2:04 pm

    • It appears that Republicans do plan to both repeal and replace Obamacare through reconciliation. The idea is to completely de-fund Obamacare, create a replacement plan and fund it (probably at much lower level). The Obamacare rules would still be there, like forcing insurance to cover people with preexisting conditions, but those rules would not apply to insurance issued under the replacement plan. There would be some new set of rules or the rules would be delegated to the states.

      Some of the current ACA rules apply to employer insurance too, like ban on life time coverage caps and requirement that plans cover children until they are 26. It is unclear to me if they can change those rules in the employer market through reconciliation.

      It is also becoming clear that when Trump says he wants everyone to have access to health insurance, he just means everyone has the option of buying a policy, not that the policy would be affordable. Whatever plan comes out of a Republican Congress will be less affordable for middle and low income Americans.

      mikeca

      January 19, 2017 at 9:45 am

      • “less affordable” –

        The rates under O-care were going up next year. It’s reprehensible for the Republicans to gloat over that, but still.

        This from The (UK) Times:

        http://www.thetimes.co.uk/edition/news/fifth-of-new-medicines-to-be-rationed-bnwcpfhjw

        It’s behind a paywall but the headline tells all.

        And:

        http://www.telegraph.co.uk/news/2016/09/02/obese-patients-and-smokers-banned-from-all-routine-operations-by/

        Britain’s NHS is not the way to go.

        gothamette

        January 19, 2017 at 1:41 pm

      • The rates under O-care were going up next year. It’s reprehensible for the Republicans to gloat over that, but still.

        Health insurance rates go up every year. The current ACA rates are about in line with the CBO estimates before the plan started. Initially they were below the CBO estimates, but now they have caught up.

        There are some mostly rural areas where their is only one provider available and therefore no competition. Rates in those areas are higher than they should be, but that is a “feature” of any market based system.

        Republican plans are more market based. They want 55-65 year olds (Trump’s base voters) to pay higher premiums so that young people can pay lower premiums for example.

        Republicans always talk about high risk pools too. The idea is to get all the high risk individuals out of the general health insurance market so companies can charge lower premiums in that market. Most high risk pools sell coverage at 150-200% of the going rate for non-high risk individuals. So if you were paying $800 per month under ACA, you would be paying $1200-1600 a month in the high risk pool. Insurance in high risk pools usually comes with very high deductibles and may not even cover the conditions that forced you into the high risk pool for the first year. Many states put enrollment limits on their high risk pools, so some people had to wait years to get into one. In spite of all that, the high risk pools lost money because the people are so sick. They require subsidies from the government to make up the losses. That makes high risk pools expensive for the government as well as the people in them.

        In the transition to the ACA, high risk pools were used before the ban on preexisting conditions went into effect and some states had operated them for years. Even with all the mechanisms used by states to limit enrollment in high risk pools, in the last few years before the ACA went into effect, the total government subsidies for the high risk pools was around $3 billion per year. The Paul Ryan plan proposes implementing high risk pools with about $2.5 billion of funding, but that level of funding will only work if high risk pools are limited. If everyone that wants into one can get in, it will require more funding.

        In high risk pools you get very expensive lousy insurance with a big government subsidy. I don’t really think that is the best way to handle the problem.

        mikeca

        January 19, 2017 at 3:57 pm

      • “The rates under O-care were going up next year. It’s reprehensible for the Republicans to gloat over that, but still.”

        Why is it reprehensible? The collapse of the exchanges, the “death spiral,” has been predicted by most Republicans since we first started debating Obamacare in 2009. The Republicans opposed a plan that was doomed to failure, it failed, and they absolutely should point that out, as well as point out everyone who poo pooed that. There is nothing reprehensible about being right.

        Mike Street Station

        January 20, 2017 at 7:05 am

      • There’s nothing reprehensible about being right, but it is wrong to gloat over the fact that average ordinary eople are suffering. This is a case of style being substance.

        gothamette

        January 20, 2017 at 10:13 am

      • “Health insurance rates go up every year. The current ACA rates are about in line with the CBO estimates before the plan started. Initially they were below the CBO estimates, but now they have caught up.”

        But I thought Obamacare was supposed to take care of all that. Oh wait, you mean to tell me that Obamacare does not overturn the laws of the marketplace? Also, people are forced into these exchanges. They can’t opt out otherwise they have to pay a penalty. Do you have anything to say about the links I put up about Britain’s NHS?

        gothamette

        January 20, 2017 at 10:16 am

  21. The only reason a heart transplant costs $600K instead of $100K or $60K or what have you is because the medical monopolies are able to post the charge after you’ve had the operation and garnish your wages to collect.

    If .gov comes in and says you have to post the price beforehand and stick to it, that will be the end of the $600K heart transplant. It will be done for the lowest price possible where every actor makes a profit. If someone who works in a hospital can actually post the price of all the equipment and staff involved, it’d be helpful in analyzing, but I guaren-fucking-tee you it is not $600K. If English doctors working in India can do it for 10% of the price, then we can do it in the US for not much more than that.

    Here’s an example:

    http://www.seattletimes.com/nation-world/us-man-defies-doctors-advice-gets-heart-transplant-in-india/

    This is just another infuriating example of lies and distortions, not unlike immigration, being used to fuck over the American people. Gentle and highly forgiving rubes that they are.

    Part of the problem is the higher education industry (always the first link in the chain and a constant thorn in our side) saddles speciality doctors with $400K+ of debt before they are able to make the first surgery. Then said doctors scoff indignantly when you tell them the cost of their services is too much. So here once again the American people subsidize the vultures of higher ed. It’s beyond infuriating.

    OldTimer

    January 18, 2017 at 12:43 am

  22. The real problem with obamacare is it revealed the agenda of the Democrats. For all their endless whining about fairness, this was just a tax increase disguised as a healthplan. The sleazy slush funds called euphemistically “exchanges” are just crony capitalist bank accounts to fund campaigns and enrich Democrats. Nearly nothing actually provides healthcare in this “plan”. The invaders get dumped into the already overstrained Medicaid pool, and the money goes straight to Democrat Operatives. People who realize these “plans” are a scam have to pay a “fine” or tax to the same sleazy crooks in the Democrat Deep State. Its fraud disguised as charity. Only a sucker would call this “healthcare”.

    Joshua Sinistar

    January 18, 2017 at 7:34 pm

  23. On consideration, I think Trumpcare is the wrong place to start for Trump. He’s spending political capital on the pet issue of a lot of bad actors in his party. But Trump didn’t make a big deal out of Obamacare during his campaign, so why do it now? It might even be better to leave Obamacare in place and let people feel it good and hard for a while before implementing an alternative. How will voters know it’s a failure unless they feel it? Will a hastily concocted replacement be any good or just another expensive, incomprehensible kludge? No, this seems more like he’s been coopted by the usual gang of fools.

    What Trump should initially be spending that political capital on, is fixing the immigration disaster, getting US firms to create jobs in the US, and (discreetly) draining the swamp. Those are signature MAGA issues. Replacing Obamacare is not a signature issue.

    Hey Bannon, call me and I’ll give you some more pointers about strategy.

    Glengarry

    January 19, 2017 at 9:12 am


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