Lion of the Blogosphere

Trump should ditch the Paul Ryan plan

Chris Ruddy from Newsmax, who is pro-Trump, argues that Trump should abandon the stupid Paul Ryan plan and instead support expanded Medicaid among other things.

This would be smart for Trump do to. I’ve previously warned that Trump could lose reelection in 2020 “if the repeal of Obamacare becomes a mess and PR disaster,” and Chris Ruddy is right, Trump is walking into a trap by letting TruCon hacks, whose business-as-usual platform Republican primary voters rejected in favor of Trump, set healthcare policy.

And I definitely agree with Chris Ruddy that insurance companies are ripping off Americans and we should stop helping them do that.

Written by Lion of the Blogosphere

March 15, 2017 at 2:11 pm

80 Responses

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  1. Has Trump reached out to Democrats in any substantive way? If his appointments were all trucon hacks then why should anyone be surprised if he lets those people set his policy?


    March 15, 2017 at 2:29 pm

    • I doubt many Demos could work with Trump even if they wanted to; their donors and activists are insane with Trump hatred, so trying to work with him would put their reelection at a severe risk.


      March 15, 2017 at 6:09 pm

  2. A good comment on medical insurance companies from another blog discussing healthcare reform:

    One of the things insurers do is figure out what sorts of services they are going to admit as medically efficacious, and therefore compensate. You don’t want the state doing that. You want providers and insureds to be able to take their disputes with insurers over what constitutes compensable medical treatment to an independent arbiter. That keeps the insurers honest. If the state itself is the insurance company, there is no independent arbiter, no court of appeal. And then you get Britain’s NHS, or the US VA.

    So we want independent insurers. One of the things that happens with independent insurers is that they end up insuring against costs of things like acupuncture and chiropracty, which seem to work even though medical science can’t come up with a satisfactory just so story that explains just why they work. Insurers, in other words, are simply better at figuring out what works than the government is. Consider: how would you like it if approval of the insurability of every single procedure had to pass through FDA approval? What do you think the rate of surgical innovation would be under such a regime? Ouch!

    This argument for independent insurers is really nothing more than a special case of the general argument that we don’t want the state providing goods and services that any other agent might competently provide.

    Price competition is undesirable? We *want* goods and services to be more expensive? Why?

    Andrew E.

    March 15, 2017 at 2:47 pm

  3. Obamacare has shown itself to be unsustainable. The Republicans should ignore it and let it destroy itself. The “fixes” they are proposing will only make it worse. (Removing the individual mandate will make it even more likely that healthy young people won’t be in the pool of insured.) If the Republicans do anything to Obamacare, they will own it’s inevitable failure. If they leave it alone, then it’s not their fault when it dies.


    March 15, 2017 at 3:18 pm

    • If they leave it alone, the exchanges collapse and millions in the individual insurance market will either lose coverage or it will be unaffordable.

      Mike Street Station

      March 15, 2017 at 5:55 pm

  4. “You don’t need to be Warren Buffett to figure out the biggest financial beneficiary of Obamacare has been insurance companies.”

    This is an informed opinion? Please. I guess that’s why insurance companies everywhere are climbing over themselves to offer Obamacare cover.


    March 15, 2017 at 3:19 pm

  5. I would agree that the current Ryan plan, if passed, would do to Republicans politically what Obamacare did to the Democrats, and for no good reason. It’s hard to understate how stupid the Republicans look right now. The Democrats have all kinds of plans sitting around on their servers, ready to go if given the opportunity. School shooting? Someone just hits print on a pre-existing law the Dems had prepared and in no time Schumer is in front of the cameras waving the new gun grabbing bill.

    Meanwhile, Republicans had years to get a consensus bill prepared and ready. Instead, it sounds as if they didn’t have a single meeting or discussion on it until a couple of weeks ago. Trump is going to have to lead if anything is going to get done. Ryan didn’t want the speakers job and isn’t suited for it.

    Mike Street Station

    March 15, 2017 at 3:27 pm

    • That is a good point about the Democrats. I guess the Republicans just wait for a lobbyist to bring them a bill because business can do no wrong.


      March 15, 2017 at 6:30 pm

    • They had this bill. The problem is it represents a pre-Trump, even pre-Tea Party consensus.

      Ultimately, Trump may need to depose Ryan. Some have speculated that this is some 3-D chess, with Trump giving Ryan enough rope to hang himself on healthcare.

      Dave Pinsen

      March 15, 2017 at 7:31 pm

    • Talk about cutting off one’s nose to spite one’s face. Are we not getting sidetracked here? Latest polls say the most important thing Trump should do is to Create Jobs at 33%. Cut taxes is at 10%. Repealing and replacing Obamacare is fifth on the list at 7%.

      Sure Ryan is a globalist. But he’s also a superior wonk who we need to get this stupid thing done. Unless everyone is fine with a moral victory? And a disintegrating Obamacare.

      To fix jobs you have to fix taxes. To fix taxes you have to “repeal and replace” using at least 50 of the 52 votes you have in the Senate. Sorry, but 60 is a pipedream, just like Trump said.

      Don’t let Obamacare overshadow the main goal. Just pass the damn bill and get on to the really important things – fixing taxes and thereby creating jobs.

      Have a little faith here in Trump. Guess what, the quicker you get this done the quicker you create jobs and the more likely you get those 60 votes by 2018.

      THEN you’re talking.


      March 16, 2017 at 1:23 am

    • All Republicans offer voters is a fantasy of themselves and independent self sufficient John Wayne types. It’s impossible for Republicans to offer anything that fulfills that fantasy because it contradicts the reality of the role of government in a modern society.


      March 16, 2017 at 3:13 am

      • As I said I hate govt, but at this point why couldn’t we just get rid of insurance companies and all the premiums that companies pay would go to the govt in an expanded medicare program. The money that employees pay out of their paycheck would also go to the govt. There would be a deductible based on how much is taken out of your paycheck.

        I have relatives that have had major operations on medicare and they went to a private hospital of their choice and didn’t have any problems with it.

        Medicare is a single payer system for the elderly.


        March 16, 2017 at 6:55 pm

      • Ryan talks about how the plan has “freedom at its core,” which is how he frames ditching the mandate. Problem is, a lot of people are dumb, and will use that freedom to AVOID personal responsibility and avoid buying insurance because they lack the capacity to conceptualize the future. So the uninsured rate will obviously skyrocket just on that basis alone, which will generate a lot of inescapably bad press.


        March 18, 2017 at 10:22 am

  6. This will never happen. There are enough Republicans that hate, hate, hate Medicaid this will never happen.

    If Romney had won in 2012 with similar control of House and Senate, a straight repeal of Obamacare would have sailed through Congress and been signed into law with no replacement.

    The problem is that this is 2017. There are 20 million people that have health insurance through Obamacare or its Medicaid expansion and a lot of them voted for Trump. Trump promised to repeal Obamacare and replacement with something better, something that would cover more people and cost less. The Ryan plan is nothing like what Trump promised.

    Of course Trump knows nothing about health care policy and just made those campaign promises because he thought that was what people wanted to hear. He has no clue how to make good on any of those promises and the Congressional Republicans will never pass a plan that would.

    Mike CA

    March 15, 2017 at 3:30 pm

    • Boring. Tell us more about Trump’s taxes.

      Andrew E.

      March 15, 2017 at 6:37 pm

    • trump, like everyone else, assumed the gop had a plan ready to go. paul ryan, and other establishment hacks, should resign.

      • It may seem reasonable to assume they had a plan (though obviously it wasn’t) but only a complete idiot would think that the GOP could offer anything any better.

        The reality is there’s a whole world of tested superior options out there because literally every first world country has a vastly better system than the US does


        March 16, 2017 at 3:16 am

  7. True post if there ever was one.


    March 15, 2017 at 3:38 pm

    • Yes, a very smart, logical, and true post!

      Except forTrump could lose reelection in 2020 is irrelevant because Trump does not want and will not seek a second term.

      E. Rekshun

      March 15, 2017 at 5:46 pm

  8. 1. Keep the Obamacare medicaid expansion.
    2. Allow interstate competition among health insurance companies.
    3. Make health insurance premiums tax deductible.

    Two in the Bush

    March 15, 2017 at 4:28 pm

    • I would modify your list a bit.

      1. Keep the Medicaid expansion, but for the expansion part, add co-payments so that amount could be credited as part of the provider payment. That will encourage more providers to accept Medicaid.

      3. Give decent tax credits for insurance premiums. The Ryan Plan starts out at $2000.00 for young people. That’s ridiculous. Even McCain’s plan from 2008 had $5000.00 tax credits to purchase insurance.

      Mike Street Station

      March 15, 2017 at 6:00 pm

      • @Mikes (Street Station &CA)

        I would favor even further Medicaid expansion but can the country afford it?


        March 15, 2017 at 8:23 pm

      • “I would favor even further Medicaid expansion but can the country afford it?”

        Long run no, which is why Medicaid is going to have to remain based on financial eligibility.

        Mike Street Station

        March 15, 2017 at 10:39 pm

  9. If you look at the comments, Ruddy has the TruCons all riled up. The majority of voters may like the American nationalist message that Trump and Bannon are pushing, but the GOP establishment is still dominated by evangelists and libertarians who have decided that if white proles are poor, addicted to drugs and unemployed, it is their own fault. Trump is fighting both the left and the right, I still think Pence and Ryan are looking to stab him in the back first chance they get.

    Peter Akuleyev

    March 15, 2017 at 5:07 pm

  10. Trump has been successful in negotiating with companies to move manufacturing and jobs back to the U.S.

    What Trump should so is let Medicare negotiate drug prices with companies, and then tell European countries they have to set their prices to those that Medicare has negotiated.

    European countries are able to barter with drug companies and secure low prices for European consumers. Then U.S. drug prices go up to subsidize them. It’s time for European and American drug prices to reach parity, and if Europe doesn’t like it, then we should stop subsidizing their defense and withdraw from NATO.


    March 15, 2017 at 5:19 pm

    • “Trump has been successful in negotiating with companies to move manufacturing and jobs back to the U.S.”

      Really? Can you cite any actual examples that aren’t just media hype?

      Peter Akuleyev

      March 15, 2017 at 5:44 pm

      • The jobs report for last month had 100,000 more jobs than expected. Time will tell if this isn’t just smoke and mirrors, but so far we have sufficient reason to believe Trump is effective at negotiating one time deals.

        Whether he can turn this into lasting, sustainable policy is what remains to be seen.


        March 15, 2017 at 8:50 pm

      • New jobs in Jan/Feb are still lag effects from the Obama administration. I don’t understand why Trump thinks boasting about that is a good idea. The one time deals, like Carrier, don’t seem to be anything but PR stunts and didn’t save many jobs. Over the long term Trump probably is scaring companies into keeping production in the US for fear of bad publicity, certainly in visible industries like the auto industry, but we won’t know for 2 or 3 years how successful he’s really been.

        Peter Akuleyev

        March 16, 2017 at 5:34 am

      • You see that with drudge, where he just went from tagging on some critical commentary to all the positive economic figures when Obama was in office to immediately trumpeting figures whole heartedly when Trump got elected. He didn’t even wait until he took office!


        March 16, 2017 at 1:26 pm

    • Your post show what imbeciles are leaders are. We subsidize rich countries’ drugs and defense.


      March 16, 2017 at 7:02 pm

  11. Politically, you are right. There is no upside for Trump in supporting this faux reform.

    On the statement of insurance companies ripping of Americans, you are wrong. At least in the context of Obamacare. Insurance companies aren’t making much, if any, money on the Obamacare plans. That’s why so many are pulling out.

    Health care is just expensive. Medicaid is about twice as expensive as Medicare because there is no cost sharing. Medicaid patients are the most entitled of all entitlement users. They can’t be managed and you’ll see them go to the ED over and over for the most trivial things. Expanding Medicaid in any way, in its current form, is an awful idea. It would be way better to expand Medicare, if anything, since 20% coinsurance is at least built in.

    DN Poolside

    March 15, 2017 at 5:41 pm

  12. Trump should lower the age for Medicare eligibility to, say, 55 y/o and let them buy in at 125% – 150% of the cost of regularly-eligible Medicare recipients.

    E. Rekshun

    March 15, 2017 at 5:50 pm

  13. I agree with Lion. Long term I would personally like to see Medicare for all. How we in the US do healthcare seems backward among OECD countries.

    R P

    March 15, 2017 at 6:18 pm

  14. Trump is turning into a dud and I was a big supporter of his. The correct answer is to break up the medical industry with anti-trust and force transparent pricing. Socialist medicine does not work in America, especially with mass 3rd world immigration. Why would white Americans be obligated to pay for brown people who showed up yesterday if the medicaid expansion went through? A market based solution is the only answer. Trump is showing a real lack of leadership on this issue.


    March 15, 2017 at 6:25 pm

    • Explain to me how transparent pricing will work. How are you supposed to shop around in an emergency? Or if you’re so sick you’re mentally impaired? How can a health care provider even give an accurate quote before hand and how can someone evaluate a new price and leave mid procedure?

      Why is it that you think every other first world country uses utility style price controls (the same thing the better dead than red United States uses in the US for water, electricity, etc.) and gets better outcomes for vastly cheaper prices?


      March 16, 2017 at 1:30 pm

  15. The only thing I would add is the best way to do this strategically is to have the Dems reject a GOP Plan and then allow Obamacare to fail. That is the best of all worlds in that it allows the GOP to argue they tried to prevent the disaster, but the Dems stopped them. So Ryan’s “3 Part Plan” needs to go. One bill that can’t be done through reconciliation and needs 60 votes in the Senate. Then let the Dems filibuster it and move on to popular things like Taxes and Immigration. When Obamacare fails at the end of the year, Dems will own both Obamacare itself and defeating the first GOP effort to “fix” it. Then Trump unveils his own plan at the start of next year that follows the principles unveiled in this article.


    March 15, 2017 at 6:36 pm

    • The comments here are good, and I’m not a fan of “3 dimensional chess” explanations whether they apply to Obama or Trump, but Trump is probably OK here letting the GoPe produce their wet dream health care plan.

      Such a plan could be passed through the House, but has already been pronounced “dead on arrival” in the Senate, and by Republican Senators at that. The Republicans really only have a majority of three in the Senate. There are nine Donk Senators representing Trump states, but these tend to be states filled with deplorables who were actually helped by much of the ACA, such as medicaid expansion. These nine Senators will be under no pressure to pass the GoPe plan, even by Trump supporters. But Republican Senators will defect, Rand Paul already has.

      So the GoPe gets their victory in the House, but the Senate blocks it before it gets to Trump’s desk. I agree that if it somehow gets through Congress it would be a bad idea for Trump to sign it into law, if only for the distraction of his core issues of immigration, trade, and no war with Russia.


      March 15, 2017 at 9:25 pm

  16. I wonder what would happen if Trump attempted to outflank everybody else by moving left with a comprehensive national healthcare plan, suddenly repositioning himself to Obama and Clinton’s left on health. It seems like the sort of thing that Trump’s WWC base would be interested in.

    Greg Pandatshang

    March 15, 2017 at 6:37 pm

  17. we’d be better off getting rid of all insurance. average lifetime health costs (accidents, flu shots, birth control, aids meds, everything) is $268,700 for men, and $361,200 for women.

    adjusted for life expectancy that’s $3,592.25 and $4,509.30 per year respectively. average income is ‎$35,876, so most adults can pay out of pocket for all of their lifetime healthcare needs. total medicaid/medicaid spending is $1191.3T.

    $1191.3T/324M = $3676.85. remember, i’m not counting schip or the va system.

    universal health savings accounts mean most people don’t need health insurance because the 2.9% fica tax covers almost all healthcare expenses.

    a slight tax increase (or no tax increases, but shutting down schip/va) means very expensive people (mostly the elderly) can be covered.

    • EDIT: the 324M population number includes all non citizens. the hsa subsidy would be about $4,000 if it was restricted to citizens (duh).

      health insurance is overrated.

    • My take, channeling NNT, on average it is great. Like I can take a 1 meter fall all day. The rub is the 10 meter fall that is devastating physically. I can’t chop those into a series of 1 meter falls.

      The post 20% kick in to Medicare idea is great to handle costs of 10 meter events with a bonus of everyone having skin in the game to avoid them to begin with.


      March 16, 2017 at 10:55 am

    • But what if you have a 100,000 dollar bill for an operation? Would the govt pay that ? People don’t incur expenses equally every year.

      Our current system does have a lot of waste, but the real problem is insuring those that can’t afford it. If everybody had a job with health insurance there wouldn’t be much of a problem,except the waste.

      We could just have a national health insurance fund where all the money goes.This fund would be on its own so the healthcare money would be transparent and not hidden in the budget.

      You could take part of money out of people’s paychecks and employer contribution.

      Everybody who works also pays for medicare which is used for today’s elderly.

      There also could be a certain percent sales tax that goes to the fund.

      There could also be a tax on property that you would pay with your real estate taxes. The rich would pay more because they usually have expensive property.

      There also could be a tax on huge investment profits which they rich would pay. Smaller amounts per year would be exempt for the average investor.

      There would be no insurance companies, so that right there would save a lot.

      You could choose any hospital or doctor you wanted.

      If we spent more than we brought in to the fund during the year, we would just run a deficit, but it would be isolated from all other govt spending so we would know how to manage it.


      March 16, 2017 at 7:21 pm

  18. Why do we need for profit insurance companies? What do they provide? They just collect the money and take a profit which raises the cost.

    You could just have associations that are non-profit if you don’t want the govt involved.

    As much as i hate the govt we might as well have some form of universal coverage since we aren’t going to eliminate taxes in our lifetime.

    Why can’t there be a national real estate tax that will go for health care? That is an easy tax to collect.

    It doesn’t have to be added on the income tax.

    Ideally we would get rid of income taxes but it won’t happen so we might as well get something for the hassle and intrusion by the govt in our lives.

    All the other rich countries seem to cover everyone and do it for less.

    Doctors charge huge amounts for very little care. I was at the doctor and the guy charged 300.00 and did a cursory exam that lasted 5 minutes. This has to stop.

    There are also many tests “just to make sure” that are really unnecessary a lot of the time, but the doctor probably makes a profit off of all these tests.


    March 15, 2017 at 6:54 pm

  19. Pascal-Emmanuel Gobry suggested a simple and brilliant alternative: scrap everything, and have the government backstop everyone if their healthcare bills are more than 20% of your income in a given year.

    What’s great about that is the 20% figure is variable in dollar terms, so physicians and other healthcare providers can’t game it. And because the upper middle class and rich will end up paying a lot out of pocket in dollar terms, they will have an incentive to bring down healthcare costs (which they don’t now, because they usually have great insurance).

    David Pinsen

    March 15, 2017 at 7:02 pm

    • this plan is reinsurance. it’s good. give everyone a medicare card they use to track spending. once you hit 20% of after tax income from the previous year medicare kicks in for the remainder of the year.

    • And how are you supposed to shop around in an emergency? Or if you’re so sick you’re mentally impaired? How can a health care provider even give an accurate quote before hand and how can someone evaluate a new price and leave mid procedure?

      Traditional pricing can work for certain limited kinds of medical procedures but anyone suggesting that the whole system can work that way is a moron. The only system that is proven to work is government price controls where government experts set a fair price. Which is what we’ve been doing for utilities in this country for hundreds of years.


      March 16, 2017 at 3:37 am

      • There was a WSJ article years ago when I had a subscription about how an Amish group handled healthcare. For emergency care, they negotiated rates ahead of time with a local hospital, for every contingency. The hospital gave them a discount because they didn’t have to hassle with insurance and the Amish never sued. And the Amish had their own insurance among themselves to help individuals pay for emergencies.

        For non-emergencies, they went to Mexico and saw US-trained dentists and physicians for a fraction of American costs. They also enjoyed staying in modern hotels for a few days.

        David Pinsen

        March 16, 2017 at 1:14 pm

      • “There was a WSJ article years ago when I had a subscription about how an Amish group handled healthcare”

        I saw a show on PBS a few years ago about a Christian community in Chicago where everybody lived together in an apartment building and they also had some houses. Everybody just gave the community their paycheck and then they decided what everybody needed.

        They didn’t buy health insurance. They just spent the money on what people needed. if there was a large bill they just paid for it.

        I don’t know what they would do if somebody had a $500,000 bill. They didn’t get into that much detail.


        March 16, 2017 at 6:17 pm

      • Sounds like communism to me.

        Lion of the Blogosphere

        March 16, 2017 at 7:01 pm

      • Sounds like communism to me.

        It’s not Communist if proles don’t benefit.

        The Undiscovered Jew

        March 16, 2017 at 9:04 pm

      • “Sounds like communism to me.”

        The means of production are still in private hands.

        They are living in a capitalist society and decided without the coercion of govt to share living expenses,

        Families also do that. There used to be 3 generations living in a household, especially on farms.

        It’s a form of mutual aide or protection. Instead of the govt having a safety net the community provides it.

        They can also put pressure on someone who decides not to work,so it’s harder to be a “welfare queen”.

        This society isolates people and makes them dependent on govt if they run into problems in life.

        I knew an H!B from India who said our govt breaks up extended families by govt assistance. People now expect the govt to take care of their parents in old age through social security or siblings and children through welfare,


        March 16, 2017 at 9:41 pm

      • OK, so it’s a COMMUNE within a capitalist society. If you make the commune big enough, you have a communist nation.

        Lion of the Blogosphere

        March 16, 2017 at 10:55 pm

  20. the u.s healthcare system is a confusing mess. the last thing you want a healthcare system to be is confusing– everybody needs healthcare, including low IQ people. you ideally want a healthcare system to be as simple as possible so low IQ people have no problem using it. i personally think the british NHS is the best for meeting this criteria.

    james n.s.w

    March 15, 2017 at 8:09 pm

    • I have friends with family in England and who have lived there for extended periods themselves, who are SJW types but refuse to vote Democrat here in the US out of a reflexive horror over their experiences with the NHS and never want to see national health care in the US.

      Andrew E.

      March 15, 2017 at 10:20 pm

      • NHS is beloved in England. Aneurin Bevan is a beloved figure


        March 16, 2017 at 3:27 am

      • I have met Americans who have chosen to remain in the UK because of the NHS. Granted they are artsy types who can’t afford decent health coverage in the US. But even wealthy Americans who live in the UK seem to do OK – you are allowed to buy private coverage. The problem with the NHS is the same problem single payer will run into in the US – it is being burdened by immigrants. If Trump really can significantly reduce the number of illegals in the US, I suspect a lot of opposition to single payer in the US will fall away.

        Peter Akuleyev

        March 16, 2017 at 5:37 am

      • LOL thats what every american says “oh my god the wait times or whatever in [X] are SO BAD that they actually come over to america to spend thousands of dollars on healthcare service instead, the free market works!!!” i don’t believe anyone who claims that shit.

        james n.s.w

        March 16, 2017 at 6:05 am

      • “LOL thats what every american says “oh my god the wait times or whatever in [X] are SO BAD that they actually come over to america to spend thousands of dollars on healthcare service instead, the free market works!!!” i don’t believe anyone who claims that shit.”

        I think the rationing is what scares Americans off from a NHS system. The Brits do have a formula to limit health care (NICE). In the early days of the Obamacare debate, Obama did a TV interview in which he seemed to support health care rationing, particularly for the elderly (except his grandma-he was talking about other people’s grandma). That helped generate a lot of the opposition to Obamacare and as a result, it’s never enjoyed majority support.

        Meanwhile Medicare has solved the rationing problem by just spending more and more money every year.

        Mike Street Station

        March 16, 2017 at 10:00 am

      • LOL thats what every american says “oh my god the wait times or whatever in [X] are SO BAD that they actually come over to america to spend thousands of dollars on healthcare service instead, the free market works!!!” i don’t believe anyone who claims that shit.

        Top hospitals in the U.S. are full of wealthy foreigners who have come here for treatment.

        David Pinsen

        March 16, 2017 at 1:16 pm

      • American insurance companies ration too. It’s just that republican voters are idiots who think they either are rich when they aren’t or will be rich soon when they won’t be and so they imagine they’ll have the really expensive non rationing insurance whenever they actually get sick. It’s called Joe the Plumber syndrome.


        March 16, 2017 at 1:23 pm

      • Well, the elite of rich countries always comes to the US for treatment. But it’s dishonest to suggest that because, say, some Swedish prince is willing to pay out of pocket to skip his country’s wait times, that is somehow a very common lived experience.


        March 18, 2017 at 10:33 am

    • I know people who live in England and they have no problem with it. They also spend a lot less than we do.

      We will never have that here. We might get a single payer type system. Medicare is kind of a single payer system anyway.

      The govt doesn’t have to run hospitals. The would just pay them like Medicare.

      We definitely have the most convoluted system in the world. It’s ridiculous.


      March 15, 2017 at 10:42 pm

  21. The thing that infuriates me bout this issue is that Dems flooded America with 3rd world filth. And now Americans are forced to provide them with free food, housing, education and health care. Worthless shits who only migrated to sponge off others.

    The problem with repealing/replacing is that so many people want so many different directions that you’ll never satisfy enough of them to make it politically smart to do anything major. If it’s really going to implode then it’s best to leave it alone so that Dems get the blame. But there are still a few things one can do to improve things.

    Increase competition across state lines.

    Create tax deductible health savings accounts

    Stop making Americans subsidize foreign patients’ drugs.

    Make sure government subsidies are strictly means tested.

    Keep the mandate because its necessary for everyone to have insurance just like it’s necessary for every driver to have liability. It can be a crappy, high deductible policy. But anything hospitals would be required by law to provide should be covered by the policy.

    They may not be able to cancel existing policies without a backlash. But they can stop subsidizing policies with expensive coverage to new customers and let attrition take care of the rest.


    March 15, 2017 at 8:10 pm

    • yes immigrants are moochers but they have nothing on the medical system itself which mooches 2 trillion dollars a year above and beyond the average per capita spending of other first world countries. A free market doesn’t work for health care the same way it doesn’t work for utilities like electricity and water.


      March 16, 2017 at 3:30 am

      • The US subsidizes the medical care of other countries, like it subsidizes defense. Arguing about what they do “more cheaply” is a non-starter.

        We’ve had this discussion before.

        Most medical equipment, from needles to pharmaceuticals are made in the US, where it is possible to turn a profit on developments. Foreign nations sponge off the US, demand a cost-plus model for drug imports and then US companies stick the rest of the profits on American citizens.

        This needs to change.

        Medical exports are required to get the American price in foreign transactions, or the nation learns to do without or make it in-house. Then we won’t have to hear about the benefits of foreign socialized medicine anymore while subsidizing out own patients.

        Time to remove the parasites.


        March 17, 2017 at 2:43 am

    • Total costs don’t mean much unless you break it down and look at the details responsible for those costs. Sure, Americans spend more money per capita. But it’s not distributed evenly across the population. In fact, 50% of the spending goes to help only 5% of patients — newborns with serious issues and the elderly, who are often quite ill.

      Countries with commiecare don’t have those expense because their bureaucrats and accountants have decided they’re not worth the effort. It’s easy to keep costs down when you ignore the sickest people and just let them die. That’s the “benefit” of a big system run by the state. That’s not possible in a private, free market system because the state isn’t making the decisions. Private parties are making those decisions based on insurance contracts. Individuals aren’t going to lay down and die just to save insurance companies a few bucks.

      Still, it would be a mistake to assume the US has a private, free market system now. Medicaid, Medicare, VA, etc. Not to mention the industry is heavily regulated. America hasn’t had a real private, free market system in decades. Certainly not in my lifetime. You want a system run by the state? You already have it, dumbass.

      And there’s one last piece to the puzzle — the people themselves. The number one cause of death is… one’s own personal behavior. Heart disease, stroke, diabetes and cancer are the four leading causes of death and they’re largely self-inflicted. American healthcare costs would be a lot lower if people ate healthier, exercised, maintained a healthy weight and refrained from drinking, smoking, etc. Americans, especially NAMs, fall short on all those. So even if the US system was identical to Canada’s America would still spend a lot more on healthcare.

      On a more personal note, you probably think you’d come out ahead with taxpayers footing your medical bills. Which is to say, you want to sponge off others. Well, I don’t want to pay for you any more than I want to pay for the rest of them. They’re not my responsibility and neither are you. If you can’t pay for it yourself then clean up your lifestyle. And if you can’t be bothered to do that then just die already.


      March 16, 2017 at 12:21 pm

      • I can see you reckon all sorts of reasons why the american health care system is superior. And you reckon it would be even better if it were ‘free market’ oriented. And you seem to reckon that other countries don’t have infants or old people, or that other countries don’t give healthcare to their infants or their old people, or that the US doesn’t have one of the infant mortality rates in the first world, and all sorts of other completely retarded shit.


        March 16, 2017 at 1:20 pm

      • Do you even bother to think before you post? Your rebuttal was nothing but straw men.

        First, I never said I wanted a completely free market system. What I want is a hybrid system. Most of the system should be free market. With a means tested option offering limited care for those who really need it. What you want is communism.

        Second, I never said other countries don’t have newborns or elderly. I said they don’t spend as much money trying to save the sickest ones. If the bureaucrats don’t think the chances of survival warrant the costs of care then the doctors just write them off and let them die.

        And, third, if you compare America’s infant mortality rate by race you’ll see most of the difference is due to NAMs. The difference between whites / asians and other developed countries is minor. Which means the differences are due to the populations and not the system.


        March 16, 2017 at 2:23 pm

      • The US vs. rest-of-world infant mortality comparisons are bullshit; America is the only country which counts all premature births in those statistics, while other countries only count later ones, so it’s very much apples to oranges. Cuba does not include any premature births in its statistics (not that anyone other than far-left morons should be giving any credence to Cuban statistics). Unfortunately, Republican presidents can’t change how the US statistics are reported because the Jesus ‘tards would flip their gourd.


        March 16, 2017 at 6:22 pm

  22. “There are also many tests “just to make sure” that are really unnecessary a lot of the time, but the doctor probably makes a profit off of all these tests.”

    isn’t that because of u.s lawsuit culture though? doctors are terrified to send somebody away without ensuring they ‘checked everything’ because of the chance of being sued.

    james n.s.w

    March 15, 2017 at 8:11 pm

    • That’s probably part of it,but I think there is a lot of unnecessary things done. For example, I had Plantar Fasciitis and went to the foot doctor. He does a couple of x-rays on my foot to make sure I don’t have a stress fracture. I could have told him It was very unlikely. I didn’t need the x-rays. Does he make a profit off of the x-rays? It’s medically justifiable but is it really necessary? Do doctors try to rack up the bill.

      My foot still hurts sometimes, so I spent almost 400.00 dollars and still didn’t get it fixed.

      I remember going to the allergist in the 80’s and the initial fee was I think 350.00. This is the 80’s remember. He didn’t even do anything. He told me to steam. He did no allergy tests or anything.

      Some countries you can’t even sue the doctor.


      March 16, 2017 at 12:46 am

  23. “if the repeal of Obamacare becomes a mess and PR disaster,”

    If Trump wants to avoid PR disasters he should close his Twitter account first off.

    Lion of the Turambar

    March 15, 2017 at 8:30 pm

    • Hah. Historians will write that Trump’s twitter was one of the tools that enabled him to have such a successful presidency.

      Andrew E.

      March 15, 2017 at 10:25 pm

      • Trump wouldn’t have become President without Twitter, and I don’t expect him to act differently in the future.

        Lion of the Blogosphere

        March 15, 2017 at 11:21 pm

    • Great you guys have a counter factual and an appeal to authority based on a prediction of future events.

      Trumps campaign was most effective when someone, probably Alies, kept him on message in the last two weeks. Before that he could be counted on dealing self inflicted wounds any time someone tried to bait him.

      Lion of the Turambar

      March 16, 2017 at 8:24 am

  24. Trump could have used this as leverage. It was a weak move to start with this. You keep the promise far off. After, he should say, we reduce legal immigration by 80 percent will we even discuss repealing and replacing Obamacare. It’s not quid pro quo. It’s setting priorities.


    March 16, 2017 at 1:11 am

  25. Forget insurance companies for a minute. The entire premise of US healthcare is totally nuts and dysgenic for two reasons:

    1) illegals getting medicaid and free ER visits. No more welfare for anyone, let alone illegals.

    2) A massive percentage of money goes to old people in the last few years of their life. A huge amount of time and effort devoted to people who are going to kick the bucket shortly anyway and all the tests and procedures in the world will not change that.

    All of these resources are going to the very old and the R-selected; again total dysgenics. A society’s resources should be going to the young (who are being screwed) and subsidizing their marriage and children.


    March 16, 2017 at 8:47 am

    • 2) A massive percentage of money goes to old people in the last few years of their life. A huge amount of time and effort devoted to people who are going to kick the bucket shortly anyway and all the tests and procedures in the world will not change that.

      A family friend got a valve replacement in his late 80s. He’s in his 90s now. He’s rich, had insurance, and the hospital, the physicians, nurses, etc. all got paid for the operation, and he got to keep living independently. Seems like a win all around. What’s the point of healthcare if it’s not used on those who need it? It’s not as if some young person with the same condition didn’t get treated because he did.

      David Pinsen

      March 16, 2017 at 1:20 pm

  26. Lion, this is OT-ish, but it’s budget related. Given your climate interest, think you’ll find this interesting how Obama deliberately pushed climate change funding across multiple government organizations so it would be harder to find and stop. $77 BILLION spent from 2008 to 2013. That could build like seven walls.


    March 16, 2017 at 5:45 pm

  27. You have to go back to Clinton to find a president who was willing to exert any sort of leadership on healthcare. Despite the name, Obamacare was farmed out to congressional Dems which is why it was such a dog’s breakfast. And now the same is happening with Trumpcare. I wish we could get a president who actually cares about this issue as a policy question to be solved, rather than just a topic to demagogue on.

    My suspicion is the GOP bill will, in fact, pass because the internal dissent has been grossly exaggerated by the press. And then Trump will just use his “master persuasion” skills to convince his base that the thing he signed is super fantastic. And we’ll move on, but no meaningful improvement to the healthcare system will have occurred.


    March 18, 2017 at 10:43 am

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