They offer you a bone called THC. Just be happy with that for your ‘health care’ until you get euthanized.

“…should repeal but they won’t.”

Do you think they have 60 votes to do so? Or do you think they should end the filibuster forever to do so? Do you think total repeal vs. the piecemeal replacement is worth making that move?

Personally, I think that repeal is a red herring. I couldn’t care less if they totally repeal and then replace, or basically replace and accomplish a de facto rather than de jure repeal through a process of legislation, more legislation, and executive action.

I’m well aware of EMTALA, having written about it myself more than 3 years ago:

http://commonsensematters-cw.blogspot.com/2013/11/ronald-reagan-emtala-roots-of-obamacare.html

I disagree with this mandate and think Republicans would be wise to repeal it, which they won’t; but even this homage to failed judgment could be rectified if we just said: “Okay, we’ll treat you if you come to the emergency room without insurance, but we’re STILL going hold YOU responsible for the bill, and not make up the cost of your treatment by raising costs on everyone else.” Don’t you think more people would go ahead and buy insurance rather than take the chance that they end up with a big fat bill for a trip to the emergency room? And if they didn’t, so be it. Put them on a payment plan and let them pay THEIR bill. Why is that so hard and so inconceivable?

I’m befuddled by you, because you go through the trouble of explaining to me why health insurance costs are soaring, i.e. because the insured essentially absorb more and more of the cost of treating the uninsured and government insured, but apparently you’re okay with the Paul Ryan plan that continues this dynamic. We should be working towards weaning every able-bodied person from their dependence upon strangers.

And to answer your question, NO it is not hyperbole at all to say that the current GOP plan to replace Obamacare is fraught with peril for the future of all Americans for precisely the dynamic you described above where, instead of reducing costs by restoring the free market and personal responsibility, we simply keep passing the buck to whomever we can to foot the bill. It’s sending us down a very dangerous path as a nation, where government meddling and coddling become the norm and there are fewer and fewer natural market forces to stabilize costs. It cannot last. Just look at what’s happening in Venezuela as a consequence of the socialist mindset and demise of personal responsibility. Yes, that’s a drastic case, but we’re moving in that direction rather than away from it.

Do a little research and see a chart of what’s happened to the number of people on Medicaid and the cost. Notice how the graph line keeps going up and up. You tell me where it ultimately ends if we don’t say enough is enough.

The real truth is that everyone in this country gets healthcare. Everyone. It’s not what we would like, but EMTALA, which was passed in 1986, makes it a crime to turn anyone away from an ER regardless of their ability to pay. Illegal immigrants and many poor people know this and get their routine care at ERs. Additionally, most big city ERs have a plethora of drug overdoses, gun shot wounds, stabbings, drunk driving accidents, etc. that will never be paid for because the patients are indigent. All that pro bono work is paid for by people who have insurance. Medicare pays much less than what most insurers pay and that shortage must be made up. Medicaid pays even less than Medicare. More shortages to be made up. That is why health insurance costs keep going up. The big argument that no one is addressing is, who pays? The cost shifting by medical providers is why medical costs are so opaque. They don’t want anyone to know who pays what. I don’t know, but suspect that some hospitals may be making huge profits. I know our local hospital, a regional non-profit, pays its administrative staff very handsomely. CEO makes $500,000.

I once asked a doctor what a procedure would cost and he looked at me like I was crazy. He said, “You’ve got insurance, don’t worry about it.” Yeah, but my insurance only paid 80% of the bill. I wanted to know what my out of pocket costs were going to be. 20% 0f $50,000 is big money for me.

CW: “My response: Obamacare repeal WITH the kind of transition Paul Ryan & Co. are proposing is fraught with peril for the future of all Americans.”
That’s right up there on a par with: “Trump is going to create a fascist state.” Hyperbole a bit?

Frog: “85% of the uninsured before Obamacare were enrolled in Medicaid through the exchanges. Eighty-five per cent! An equal number, roughly, have become effectively uninsured due to Obamacare with its engendered high premiums and high deductibles.”

Yes, Obamacare is awful. What I do know is what Obamacare has done to our daughter, a small business woman. Her Obamacare premiums and deductibles have doubled, she had to find a new doctor, and in 2017 she has only one choice of insurers. She makes just a bit too much to get any subsidies, so she pays the full premiums with after tax dollars. She is thrilled by the new plan. Her premiums may not go down, but she will be able to choose from several insurers and find a plan that fits her needs. – as it was for her before Obamacare. That she will get a bit of tax credit also makes her happy. At least that’s what she tells me.

My response: Obamacare repeal WITH the kind of transition Paul Ryan & Co. are proposing is fraught with peril for the future of all Americans.

J.J.: “You cannot dictate personal responsibility.”

My response: Of course you can. You do it by refusing to rescue people from their own failures and poor choices. People do it all the time. Our federal gov’t expects you to take personal responsibility for the taxes you owe, don’t they? They impose a consequence on you for failure to pay, right? The consequence of not getting health insurance is that you risk getting a really big bill which you are required to pay if you get sick or hurt. Problem solved.

Never forget the profit motive.

The msm don’t move as a monolith, nor can they ignore the economics of their industry to push a political agenda.

They have an audience for what they produce (which happens to be a broad / sizable swath of our country).

Infighting on the right is newsworthy to their audience .

Some of my comments:
– what the heck is an advance-able, refundable tax credit?
-why are we giving money away (tax credits) to people who barely pay taxes? I know, I know, to make their lives better. Sure.
-why is there a 30% surcharge payable to an insurance company over and above the age-adjusted, health-adjusted premium if health insurance has not been in force for 63(!) or more days? I understand it is intended as a penalty where there should be no penalty, but payable to an insurance company?
-Why must there be a penalty? To herd us in the “right” direction, to universal coverage. Left, meet Right.
-why is universal health care coverage a desideratum? Indeed, now a declared right of coverage for all people?
-The non-profit hospitals will persist as non-profits, paying zero taxes, even though they all make sizeable profits, usually with annual revenues exceeding $1 Billion for hospitals above 250 beds. Why? No free or charitable care is or will be provided by them under Obamacare or GOPcare.

The GOP has had more than two years to come up with something, and this is their first (best) shot?

Did you know there are over 10,000 sections in the Obamacare law? No? Neither does Pelosi.

I think Ryan is a bad man, a dissembler, a cockroach. But I don’t have strong opinions!

I agree with all your comments. All good conservative points. However, if the repeal and replace effort does nothing to help those who are on Obamacare now, we can expect to lose at least the Senate and possibly the House in 2018. Politics is the art of the possible. In a country filled with people who know nothing except what the MSM tells them, (and the MSM will trumpet the stories of any who lose coverage) abrupt change is extremely difficult. Obamacare repeal without some kind of transition is fraught with peril for the GOP.

You cannot dictate personal responsibility. If you could, we wouldn’t have a drug addiction epidemic, or a homelessness problem, or even much crime. Unfortunately, we humans are not perfectible.

CW: “No, the Paul Ryan does not equalize the tax treatment between people who pay out of pocket and people who get insurance through employment.”

You’re right, in most cases, it doesn’t. Say an employee between age 30 and 39 gets coverage for which his employer pays an annual premium Of $6,000. If the employee had to pay a tax rate of 25% on that figure they would have to pay the IRS $1500 in taxes.

If an an individual buyer pays $6000 for his/her policy and is between 30 and 39 years old he/she would get a tax credit of $2000. That is a $500 advantage. The advantage is put there, IMO, to incentivize the 11 million individual policy holders to continue to buy health care insurance under the new paradigm, which includes a wide choice of plans, and eventually, buying across state lines. Ryan believe people respond to financial incentives. So do I.

It would need 60 votes, which they don’t have.

Or they’d have to do away with the filibuster altogether, which has its own dangers.

They believe that with a combination of reconciliation and executive orders, they can change and improve it dramatically without technically repealing it in full. That probably could work, too, if they could agree on what they wanted to do. The present changes are not the final stage, and a lot of people don’t like them, but that doesn’t mean the method of change is the problem.