The fall of Trumpcare

[Jeeves]

[It would have to cover R&D costs, so it would be higher than the current Canadian price.]

That probably isn't the case. American drug companies recover their actual R&D easily at current Canadian prices, plus a solid profit.

Even at the self-reported amounts spent on R&D, almost all drug companies spend much more on marketing, and most book more money as profit than R&D: http://www.bbc.com/news/business-28212223
Then figure that the self-reported R&D covers a lot of activity whose real purpose is to extend patent protection and the like.

And to settle law-suits and hire expert witnesses and bogus test-results, yes.
In fact, they make a healthy profit at Canadian prices, and probably do quite well, even at the Mexican prices.

It's possible that we might see more money spent on true R&D, rather than less, if we bled the big money from the pharmaceutical business.

Regulation and oversight is important (and probably next on the budget chopping-block), especially since there have been quite a few dangerous products released with inadequate testing.
Another approach might be stopping or threatening to stop the research subsidies and tax exemptions.

 

[billvon]

I would be happy if the rich just paid the same amount as the middle and lower classes. That would be fair. OK, maybe a bit more.

That's not really practical. Requiring someone who has no money to pay $5K a year will result in him going to jail for nonpayment of taxes, whereas a rich person won't even notice that amount. And keeping people in jail is expensive, so the remaining taxpayers see their bill go up, so more of them to go to jail, and taxes go up again . . . .

 

[joepistole]

A simplified flat tax with not loop holes is a nice idea on paper, but in real life where the rich have all sorts of different income sources it would get complicated fast, more so it would greatly punish the poor due to how they need a greater percentage of their income for basic living expenses. It would not be some much more complicated to have a logarithmic tax.

It's only complicated if you tax different income types differently. But if you taxed all income equally, it wouldn't be that difficult. I think what is being proposed is a minimum income tax, not a flat tax. A flat tax would disadvantage the poor. But if we are talking about a minimum tax (e.g. the Buffet Rule), that wouldn't be the case.

https://en.wikipedia.org/wiki/Buffett_Rule

 

[iceaura]

TSTS - I didn't say that about covering R&D costs; the drug companies did

Fixed, sorry.

 

[Jeeves]

Thanks. I believe we're reading the same stats and coming to the same conclusions.

 

[joepistole]

It's back? Republicans are now talking about reviving Trumpcare. Apparently, the pressure on the Freedom Caucus continues to mount. Right wing Christians want to get rid of funding for Planned Parenthood and repealing Obamacare would have done that for them. And then there is the fact they need the trillion dollars they would take from Obamacare to fund their tax cuts for America's wealthiest families. And then there is the fact the Republican base has demanded repeal and replace for 7 years. It has become the "remember the Alamo" rallying cry within the right wing nutter base.

But I think Trump and his fellow Republicans would be wise to let it go. He's already been badly burnt. He doesn't need to do it again. Even if he manages to get it through the House, he still has the Senate to contend with, and even then, if it gets passed, it will piss off a lot of people. When Johnny Sixpack earning 26,000 a year sees his health insurance premiums rise from 1,700 dollars a year to 15,000 dollars a year, Johnny will not be pleased. And Johnny will not care why. Republicans are hoping to sell Johnny will not notice. It's a no win situation for Republicans. I think Republicans would be wise to let this die quietly.

 

[Randwolf]

I think Republicans would be wise to let this die quietly.

I agree, that would be the wise course of action.

Unfortunately, that probably means they will do the Farragut thing - "Damn the torpedoes - full speed ahead!"

 

[joepistole]

I agree, that would be the wise course of action.

Unfortunately, that probably means they will do the Farragut thing - "Damn the torpedoes - full speed ahead!"

True; Republicans aren't known for wisdom.

 

[Syne]

After 6 years of republicans voting over and over again to repeal obamacare, now that they have total control, they could not even get a vote in the house for a replacement. The reasons are that some republican house members refused to vote yes on it, either because they felt it did not repeal enough, or because they knew what an utter disaster it would produce. Now the republicans have shifted strategies to what Trump has advocated earlier, "Let obamacare collapse, it is failing" in short instead of taking the blame for fucking over healthcare they will undermine it from the side-lines and then blame obama. In short this is not a great victory for the left, it may in fact end up a better position for the right in the end.

What Republican refused to vote 'yes' thinking it would be worse than Obamacare?

Of course they don't have a replacement plan! Obamacare its self is descended from the heritage foundation study, this whole thing is literally the republican's version of universal healthcare.

Where did the Heritage Foundation advocate, originate, or support Obamacare-like plans?

 

[iceaura]

Where did the Heritage Foundation advocate, originate, or support Obamacare-like plans?

Back in 1993 the Republicans took up a Heritage Foundation written plan from 1989, wrote a bill according to its major features, and offered it as an alternative to Clinton's initiative.

Here's a direct comparison of the 2010 ACA with that earlier Heritage Foundation developed approach: http://khn.org/news/gop-1993-health-reform-bill/

 

[Randwolf]

Where did the Heritage Foundation advocate, originate, or support Obamacare-like plans?

Did you honestly not know this Syne? I understand you're screwed either way, either you were ignorant or you were trolling - take your pick.

Back in 1993 the Republicans took up a Heritage Foundation written plan from 1989, wrote a bill according to its major features, and offered it as an alternative to Clinton's initiative.
Here's a direct comparison of the 2010 ACA with that earlier Heritage Foundation developed approach: http://khn.org/news/gop-1993-health-reform-bill/

Here's an interview for you Syne:

If there’s one thing conservatives might hate more than Obamacare, it’s hearing that Obamacare springs from Republican ideas. The Heritage Foundation, the granddaddy of the right-wing think tanks, fumed when President Barack Obama said it was the source of the concept of the health insurance marketplaces where people could shop for the best deal. (We rated Obama's claim Mostly True.)
http://www.politifact.com/punditfac...5/ellen-qualls/aca-gop-health-care-plan-1993/​

 

[billvon]

Did you honestly not know this Syne? I understand you're screwed either way, either you were ignorant or you were trolling - take your pick.

It is almost a rule of Internet forums - the more outraged a right winger is about something, the less likely he is to understand it. I am reminded of the Facebook poster who was cheering the downfall of Obamacare; he did not have to worry, he explained, because he had his healthcare coverage through the ACA.

 

[Randwolf]

I am reminded of the Facebook poster who was cheering the downfall of Obamacare; he did not have to worry, he explained, because he had his healthcare coverage through the ACA.

That's one of my favorites - see my Schadenfreude posts elsewhere. It's hard to resist drinking their tears...

 

[iceaura]

About the '93 Republican bill - it had two Democratic suckers cosponsors: https://www.congress.gov/bill/103rd-congress/senate-bill/1770/cosponsors

Just for the hell of it, not that we don't already know they were and are full of shit, we can list the Republican cosponsors of the '93 bill who voted against the 2009 ACA (every single '93 Republican cosponsor still in the Senate 16 years later did that).
Sen. Bond, Christopher S. [R-MO]*
Sen. Bennett, Robert F. [R-UT]*
Sen. Hatch, Orrin G. [R-UT]*
Sen. Lugar, Richard G. [R-IN]*
Sen. Grassley, Chuck [R-IA]*

 

[ElectricFetus]

What Republican refused to vote 'yes' thinking it would be worse than Obamacare?

They didn't vote on it, that was the point. The republicans polled their house members in private, determine they did not have enough yes votes and dropped the bill, why some of them did not vote is because they wanted more cuts or they had a moment of sanity, only they know.

Where did the Heritage Foundation advocate, originate, or support Obamacare-like plans?

This deserves a meme:

For the love of god The heritage foundation came up with obamacare-like plan in 1989.
http://americablog.com/2013/10/orig...on-created-obamacares-individual-mandate.html

That being everyone would be forced to get insurance or pay heavy fines/taxes (individual mandate) in trade insurance companies would basically be required to insure everyone even the doomed, because with everyone paying insurance the healthy could pay for the sick and the insurance companies could still skim a profit off the top. Everyone wins, especially the insurance companies with millions and millions of new clients most of whom low risk that they can suck off like the fucking parasites they are. I swear vampires run insurance companies, that and banks, with us jews.

 

[joepistole]

Republicans are once again speaking in optimistically about repealing Obamacare. Well that was brief. Just a few days ago, it was all over, and Obamacare would remain the law of the land. Now how much of this is revival just ego stroking and feeding the base, I don't know. But Republicans really do want to repeal Obamacare. One, it's a measure of their credibility with their base. For 7+ years now they have lied and fear mongered Obamacare to the point of absurdity. They not only lied about Obamacare, but they promised to repeal it on day one. And now when they control both houses of Congress they failed to do it. It's long past day one, and they couldn't even get repeal out of the House.

Equally important, Republicans want to use the trillion dollars they will save by taking away access to healthcare for 20 million Americans to fund their tax cuts for America's wealthiest citizens. Republicans have powerful incentives to kill Obamacare. So I expect they will continue their efforts to thwart Obamacare. But it will be a difficult row for them to hoe, because Obamacare has become a very popular program. The people who have elected Republicans will not be happy when their health insurance premiums go from 1,700 per year under Obamacare to 15,000 dollars per year under Trumpcare.

 

[Jeeves]

They're sailing at a Scylla of not doing it and Charybdis of doing it.
What the smarter ones - always assuming any are still alive - will opt for is retaining and renaming those portions of ACA that their constituents would be angriest to lose.
Which means, all services relating to women, infants and reproduction will be struck down, while all programs required by fat old white men will be kept.

 

[Syne]

Back in 1993 the Republicans took up a Heritage Foundation written plan from 1989, wrote a bill according to its major features, and offered it as an alternative to Clinton's initiative.

Here's a direct comparison of the 2010 ACA with that earlier Heritage Foundation developed approach: http://khn.org/news/gop-1993-health-reform-bill/

Did you honestly not know this Syne? I understand you're screwed either way, either you were ignorant or you were trolling - take your pick.

Here's an interview for you Syne:

If there’s one thing conservatives might hate more than Obamacare, it’s hearing that Obamacare springs from Republican ideas. The Heritage Foundation, the granddaddy of the right-wing think tanks, fumed when President Barack Obama said it was the source of the concept of the health insurance marketplaces where people could shop for the best deal. (We rated Obama's claim Mostly True.)
http://www.politifact.com/punditfac...5/ellen-qualls/aca-gop-health-care-plan-1993/​

LOL! Apparently you guys don't bother reading (or understanding) your own sources.
Chafee's 1993 bill was A) never taken up by the Senate, B) likely had to be bipartisan in majority Democrat held House and Senate (accounting for the Democrat cosponsors), and C) was not supported by the Heritage Foundation, as per Randwolf's link (not an "interview"):

Conservative pushback

Even before Chafee brought his bill forward, some conservatives were trying to scuttle it.

More hard-line senators such as Phil Gramm, R-Texas, House Republicans and the Heritage Foundation saw the Chafee bill as an unacceptable compromise. What they wanted was outright defeat of the president’s approach.
...
It is telling that the Chafee bill never became a full blown bill and never came up for a vote.
- http://www.politifact.com/punditfac...5/ellen-qualls/aca-gop-health-care-plan-1993/​

The 1989 Heritage Plan is not the Chafee plan, nor are either similar enough to Obamacare. The Chafee plan had an easy out for the individual mandate (iceaura's link):

Provides an exception for any individual who is opposed for religious reasons to health plan coverage, including those who rely on healing using spiritual means through prayer alone. - http://khn.org/news/gop-1993-health-reform-bill/​

The 1989 Heritage Plan seems to specify only mandating catastrophic coverage (ElectricFetus' link):

"If a young man wrecks his Porsche and has not had the foresight to obtain insurance..." - http://americablog.com/2013/10/orig...on-created-obamacares-individual-mandate.html​

And even the Chafee plan required offering a catastrophic coverage policy (iceaura's link):

Requires large employers to offer to employees at least a standard package and a catastrophic package.
...
Requires each qualified health plan to provide a standard package and a catastrophic package. - http://khn.org/news/gop-1993-health-reform-bill/​

Obamacare plan requirements strictly denied catastrophic coverage only.
So not only did the Heritage plan only require an individual mandate for catastrophic coverage, but the Chafee plan, not supported by the Heritage Foundation, allowed an easy religious exemption to the individual mandate, so it was a bipartisan olive branch that had no teeth.

Randwolf, maybe you should read past the first paragraph of your source.
Iceaura, maybe you should read all of your source as well.
Care to try again?

What Republican refused to vote 'yes' thinking it would be worse than Obamacare?

They didn't vote on it, that was the point. The republicans polled their house members in private, determine they did not have enough yes votes and dropped the bill, why some of them did not vote is because they wanted more cuts or they had a moment of sanity, only they know.

Failure to secure 'yes' votes on Obamacare-lite is not an endorsement of Obamacare over Trumpcare. The failure to secure votes was an indication of Trumpcare's similarity to Obamacare as a half-measure, at best.

For the love of god The heritage foundation came up with obamacare-like plan in 1989.
http://americablog.com/2013/10/orig...on-created-obamacares-individual-mandate.html

That being everyone would be forced to get insurance or pay heavy fines/taxes (individual mandate) in trade insurance companies would basically be required to insure everyone even the doomed, because with everyone paying insurance the healthy could pay for the sick and the insurance companies could still skim a profit off the top. Everyone wins, especially the insurance companies with millions and millions of new clients most of whom low risk that they can suck off like the fucking parasites they are. I swear vampires run insurance companies, that and banks, with us jews.

Your source doesn't mention any penalty, and actually only specifies catastrophic coverage. Both contrary to Obamacare.
Care to try again?

 

[iceaura]

Iceaura, maybe you should read all of your source as well.

I did. And I told you all about it:

Back in 1993 the Republicans took up a Heritage Foundation written plan from 1989, wrote a bill according to its major features, and offered it as an alternative to Clinton's initiative.

Here's a direct comparison of the 2010 ACA with that earlier Heritage Foundation developed approach: http://khn.org/news/gop-1993-health-reform-bill/

Meanwhile, as you throw up chaff

Chafee's 1993 bill was A) never taken up by the Senate, B) likely had to be bipartisan in majority Democrat held House and Senate (accounting for the Democrat cosponsors), and C) was not supported by the Heritage Foundation, as per Randwolf's link (not an "interview")
- - - -
Obamacare plan requirements strictly denied catastrophic coverage only.
So not only did the Heritage plan only require an individual mandate for catastrophic coverage, but the Chafee plan, not supported by the Heritage Foundation, allowed an easy religious exemption to the individual mandate, so it was a bipartisan olive branch that had no teeth.
:

keep in mind you are now quibbling over details of the Heritage/Chafee/Romney/Obama plan that the Republicans have - just now - refused to amend.

Failure to secure 'yes' votes on Obamacare-lite is not an endorsement of Obamacare over Trumpcare. The failure to secure votes was an indication of Trumpcare's similarity to Obamacare as a half-measure, at best.

So the similarity of Trumpcare to the Heritage Foundation plan makes it unacceptable to Republicans.

The problem then becomes: this Heritage model was the rightwing backstop against incoming socialism - it was supposedly a way to arrange things so that ordinary people could obtain basic First World medical care in the US, or at least be presented with the illusion of the possibility so that they would not revolt politically, without interfering with corporate capitalist profit-making or socializing any aspect of medical care delivery, and in particular without significantly raising taxes on rich people. It was the only such combination play ever invented.

So the combination play is toast. Obamacare will fail, because costs are already too high for it and they are rising, and because the amendments it needs to limp along face a Republican government incapable of such maintenance. What happens then?

 

[billvon]

Failure to secure 'yes' votes on Obamacare-lite is not an endorsement of Obamacare over Trumpcare.

Of course it was. The biggest public fear was that people would lose their coverage. They wanted to keep what they had, as Trump had promised they could, and politicians did not want to deal with the political fallout of yanking the health insurance coverage of tens of millions of voters.

People wanted to keep the ACA.

The failure to secure votes was an indication of Trumpcare's similarity to Obamacare as a half-measure, at best.

Nope. Had Trumpcare been Obamacare but better it would have passed without a hitch. Don't forget - the republicans control both houses and the presidency.

And in case you have forgotten, here's what was promised as a replacement:

"We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”
“I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid.”
“We don't want anyone who currently has insurance to not have insurance.”
“I firmly believe that nobody will be worse off financially in the process that we’re going through.”
"We have to get rid of the artificial lines around the states.
“I am going to take care of everybody … Everybody’s going to be taken care of much better than they’re taken care of now.”

If those had been true - if even some of them had been true - then Trumpcare would have passed. However, it was seen as so much worse than the ACA that even with a republican majority in both houses and a republican president, they couldn't even get it to a vote.