(11-12-2016 08:20 PM)CardinalJim Wrote:  The Republicans don't have to compromise with the Democrats. With a majority in both the Senate and House, Democrats will just need to stay out of the way. Speed bumps is what they'll be if they don't.

We didn't put them there to compromise with the liberal idiots
CJ

Trump and the GOP controlled Congress does have to do a damn thing but do the same thing the Liberals did when they jammed the ACA down our throats without even knowing WTF was in it.

I hope that does not happen. I would rather Trump assemble (as he said he would) the best minds available to attack this issue head on...without partisanship and professionally. He has the opportunity to get this right and affect peoples lives positively for decades to come. He has to attack this like he would any of his business projects...logically..unemotionally..and frugally. I hope sincerely Trump ends up a hero for solving this issue. What we have now is a dismal failure for the vast majority of Americans. We can do much better.

(11-12-2016 08:35 PM)Fo Shizzle Wrote:  

(11-12-2016 08:20 PM)CardinalJim Wrote:  The Republicans don't have to compromise with the Democrats. With a majority in both the Senate and House, Democrats will just need to stay out of the way. Speed bumps is what they'll be if they don't.

We didn't put them there to compromise with the liberal idiots
CJ

Trump and the GOP controlled Congress does have to do a damn thing but do the same thing the Liberals did when they jammed the ACA down our throats without even knowing WTF was in it.

I hope that does not happen. I would rather Trump assemble (as he said he would) the best minds available to attack this issue head on...without partisanship and professionally. He has the opportunity to get this right and affect peoples lives positively for decades to come. He has to attack this like he would any of his business projects...logically..unemotionally..and frugally. I hope sincerely Trump ends up a hero for solving this issue. What we have now is a dismal failure for the vast majority of Americans. We can do much better.

I say shutdown ACA and forget about replacing it. Socialized medicine will not work because of the deep rooted lack of personal responsibility among those that use it.
If I don't have to pay for it, what incentive do I have not to abuse it.
CJ

(11-12-2016 08:28 PM)dfarr Wrote:  

(11-12-2016 08:22 PM)Fo Shizzle Wrote:  Im a bit confused how the ACA has any effect on the members of Congress or any government employee anyway..regardless of any exemption. They all either make household incomes above 90K or have some type of government worker insurance..or both. The ACA is irrelevant to their lives. Now...if you want to push installing single payer basic insurance for EVERYONE in the country?..including govt. employees and Congress? and install some type of Bismarck approach? Now THAT would get their attention.

Low level staffers don't make $90k probably considering congressmen make like $180k.

According to my former Congress professor at Miami (who was chief of staff of a former House Majority Whip), the federal employee health plan pays over three-quarters of their annual premium. A tax-free contribution somewhere between two and five-thousand per year is a lot more more generous than income-adjusted Obamacare subsidies, and for the staffers living in the ivory towers of DC, taking that away while all other federal employees keep their plan is unacceptable. And considering how high the cost-of-living is in the Beltway, whatever they make doesn't go extremely far even before health insurance when you also factor in the insane hours they put in (especially the grunts doing the Charlie work of Congress).

(11-12-2016 08:28 PM)dfarr Wrote:  

(11-12-2016 08:22 PM)Fo Shizzle Wrote:  

(11-12-2016 08:12 PM)Love and Honor Wrote:  I'd be very careful about how I'd approach a repeal and replacement if I were Trump, given that Democrats will pull out all the stops to maintain the only real 'achievement' of the Obama administration. He could try and ram it through without them, but to go at it without any Democratic support would mean the GOP would have to either do a partial repeal through the filibuster-proof budget reconciliation process or get McConnell to throw the filibuster out the window. Both have a host of problems tied to them, but getting bipartisanship to happen with healthcare reform isn't impossible if you know how members of Congress think and how you can take to take advantage of their that.

The best way to deal with stubborn Democrats is to reinstate the effect of the Grassley Amendment, which makes congressional employees subject to Obamacare, by eliminating the SHOP exemption. With the stroke of a pen, all the sudden every single one of them is subject to the ACA again after Obama unilaterally (and unlawfully) created a loophole in 2013 because it was so unpopular on Capitol Hill.

The best way to do that is to sign an EO that ends the exemption on one year from inauguration day, creating a mob of angry staffers who'd threaten to leave the Rayburn, Cannon, Russell, and Hart buildings in droves if it takes effect. That forces Democrats to the table for two reasons: One, members of Congress can't afford to lose entire staff of loyal employees with connections to their district/state for campaigning and constituency services. And two, if they can get over that they'd get crucified by the American public; no one will have any sympathy for well-compensated congressional employees who are now forced to play by the same rules as the rest of the nation.

From there, the Democratic Party will be far more willing to compromise. It might take some marginal changes to the final health bill or some extra bridges built in blue states to whip the votes, but a bipartisan replacement will work a lot better in the long run over force-feeding.

Im a bit confused how the ACA has any effect on the members of Congress or any government employee anyway..regardless of any exemption. They all either make household incomes above 90K or have some type of government worker insurance..or both. The ACA is irrelevant to their lives. Now...if you want to push installing single payer basic insurance for EVERYONE in the country?..including govt. employees and Congress? and install some type of Bismarck approach? Now THAT would get their attention.

Low level staffers don't make $90k probably considering congressmen make like $180k.

...but they have employer provided insurance...and pretty good insurance in their pool. The problem occurs with people that have a combined household income over 90K and have have to buy their insurance product on the open market. They are essentially screwed. No pool to lower costs and..no subsidy. High premiums and high deductibles are their only option. There are a lot of people in this situation.

(11-12-2016 08:20 PM)CardinalJim Wrote:  The Republicans don't have to compromise with the Democrats. With a majority in both the Senate and House, Democrats will just need to stay out of the way. Speed bumps is what they'll be if they don't.

We didn't put them there to compromise with the liberal idiots
CJ

Trump and the Republicans could try and ram it through without them, but like I said, passing reform without any Democratic support would mean the GOP would have to either do a partial repeal through the filibuster-proof budget reconciliation process or by throwing the filibuster out the window for a full repeal and replacement. He can't do the first since it'll be seen as a cop-out with the Obamacare regulatory structure essentially staying intact. If he tries going with the second, he runs into a few problems: One, it's tough getting fifty-one senators even of the same party to agree. Two, you run the risk of compromising the final bill with such little room for error since you have to give into individual demands to keep their vote. And three, even if you can create a viable replacement out of that, Trump loses a lot of political capital in future legislative efforts and creates the same problem Obama had with the GOP and half the nation in Obamacare; political opponents have no problem disowning and trying to undermine a law they have no attachment to.

Obamacare is really the only example of modern domestic policy that was passed with literally no bipartisan support involvement. Say what you want about the Social Security Act, Civil Rights Act, ADA, or any other reform of high magnitude, but all had minority party support at some level. It's no coincidence that each of those measures have lasted so long while Obamacare is on its last legs not even a decade later. If you play Congress in the way I described, you can pass your reform mostly as you'd like to see it except at the margins. And with Trump looking to rebuild infrastructure, there's a lot of projects you dangle in front of those on the fence.

many meaningless words.

the owner of this board is a *****.

ask me why

(11-12-2016 09:18 PM)EagleX Wrote:  many meaningless words.

the owner of this board is a *****.

ask me why

Ok...

(11-12-2016 09:20 PM)Fo Shizzle Wrote:  

(11-12-2016 09:18 PM)EagleX Wrote:  many meaningless words.

the owner of this board is a *****.

ask me why

Ok...

for openers, he doesn't know if he is a Libertarian, or a libertarian

(11-10-2016 09:52 AM)Tom in Lazybrook Wrote:  Because people like you want to KILL OFF people for being LGBT.

The only people who want to kill people off for being LGBTWXYZ are the LGBTWXYZ degenerates who despite decades of public education on the subject insist upon having unprotected sex with multiple partners without using proper protection.

It's not my financial responsibility to pay for the medical care of some degenerate who decided to play a version of Russian roulette with a bunch of dude's booty holes and got AIDS.

(11-12-2016 09:23 PM)EagleX Wrote:  

(11-12-2016 09:20 PM)Fo Shizzle Wrote:  

(11-12-2016 09:18 PM)EagleX Wrote:  many meaningless words.

the owner of this board is a *****.

ask me why

Ok...

for openers, he doesn't know if he is a Libertarian, or a libertarian

What a travesty!

(11-12-2016 08:49 PM)CardinalJim Wrote:  

(11-12-2016 08:35 PM)Fo Shizzle Wrote:  

(11-12-2016 08:20 PM)CardinalJim Wrote:  The Republicans don't have to compromise with the Democrats. With a majority in both the Senate and House, Democrats will just need to stay out of the way. Speed bumps is what they'll be if they don't.

We didn't put them there to compromise with the liberal idiots
CJ

Trump and the GOP controlled Congress does have to do a damn thing but do the same thing the Liberals did when they jammed the ACA down our throats without even knowing WTF was in it.

I hope that does not happen. I would rather Trump assemble (as he said he would) the best minds available to attack this issue head on...without partisanship and professionally. He has the opportunity to get this right and affect peoples lives positively for decades to come. He has to attack this like he would any of his business projects...logically..unemotionally..and frugally. I hope sincerely Trump ends up a hero for solving this issue. What we have now is a dismal failure for the vast majority of Americans. We can do much better.

I say shutdown ACA and forget about replacing it. Socialized medicine will not work because of the deep rooted lack of personal responsibility among those that use it.
If I don't have to pay for it, what incentive do I have not to abuse it.
CJ

Part of the solution to all of this has to be a PPO type setup. Need to see a doctor? $15 copay due when you arrive in the office. I believe Indiana does something like this. There can be no free rides. It needs to be affordable, but it also needs to be accountable.

Also, if you have subsidized healthcare, there are limits to the care you can receive per year. If you want something different, pay for it. Right now we have the exact opposite. Those who pay nothing can get all the care they want and be completely subsidized. Those who pay cant afford to get care. F*ck that.

That's not the defining principle of an HMO. You can have an HMO with a copay.

The defining principle is whether or not the doc gets paid more to see 11 patients than 10.



Whether the ACA is repealed or not will be a matter of opinion and/or structure rather than effect.

The individual mandate will likely be gone... at least for a 'full coverage' policy. There may or may not be a 'minimum' requirement like their is for cars, and while everyone may be given it, it may not be what anyone who can afford more will want.

I imagine a 'free' system similar to medicaid where docs/clinics/hospitals who take medicaid would provide basic and catastrophic services for a contracted amount... and those who wanted more access but no more coverage would have to pay a premium for that access to those same docs. People with more money would opt out of the 'free' system entirely. Again, functionally more like what we had before, but sounding more like what the ACA does (so that you don't kick 20mm people off the rolls... which was a lie then and is a lie now, but whatever)

Keep kids on until 26 will stay because it is meaningless in terms of cost
uncapping policies will stay because it is meaningless in terms of cost
PECs will stay, but will be specifically supplemented through either sin taxes or other state funds previously 'high risk' pools.


IF the ACA remains in any function it will be so that republicans can use the money it raises, but not be responsible for having caused the raise.

I mean, what difference does it make if you are covered under medicaid, and can see a doctor that takes medicaid (the case for most subsidized people before the ACA) OR you are covered under 'hmoBronze' and can see a doctor that takes hmoBronze?


I'm betting there will be a bill titled something like 'the ACA repeal and replace bill' that doesn't actually repeal and replace every aspect... just the troublesome ones or the ones that lied about what they did.

To the end user, the comparison of HMO vs PPO isnt how they deal with paying doctors (although you're correct in thats the ultimate difference) To the consumer, a PPO always looks like a better plan (and was almost always the better plan) because of the usual lower price of the co-pay, what the co-pay covers, and the broad spectrum of doctors that can be used. I've had PPO's that paid 90/10 in plan and 80/20 out of plan, with a deductible in the hundreds instead of thousands. Thats real insurance with real freedom of choice tha tcan be used.

(11-13-2016 03:44 PM)UofMstateU Wrote:  To the end user, the comparison of HMO vs PPO isnt how they deal with paying doctors (although you're correct in thats the ultimate difference) To the consumer, a PPO always looks like a better plan (and was almost always the better plan) because of the usual lower price of the co-pay, what the co-pay covers, and the broad spectrum of doctors that can be used. I've had PPO's that paid 90/10 in plan and 80/20 out of plan, with a deductible in the hundreds instead of thousands. Thats real insurance with real freedom of choice tha tcan be used.

Hmos generally require referrals as well which are a pain in The @$$