The Best Health Care System in the World! Here's a list of problems...

Did you ever wonder what was wrong with the US health care system, while a mod of profiteers pound their chest saying it's the best system in the world?

The Senate came up with a list of reforms that highlighted what is currently wrong; nightmarish gaming of the system robbing Americans of their hard earned money.

Remember, the cost, the maze of procedures, and the constant oversight would not exist under universal health care. Think of the savings:

The Senate health committee released its draft legislation to tackle healthcare costs, with provisions that read like a road map of how hospitals and insurers use contracts to dominate their competitors, consolidate their business and keep patients in the dark; mend loopholes exploited by hospitals, insurers, and manufacturers; and cut some fat out of the healthcare industry through simple reforms.
1. The ban on surprise medical bills.

2. Force air ambulances to separate out medical charges from the transport costs in the bills they send to patients and health plans.

3. Mandate patients receive their full bill within 30 business days. If the bill comes later, the patients wouldn't be obligated to pay.

4. Hospitals, physicians and health insurers would have to give patients "good-faith" estimates of their out-of-pocket costs within 48 hours of a request.

5. Insurers' provider directories would have to be kept up to date.

6. Provisions would correct hospital and insurer manipulations of contracts, which play a big role in setting the prices patients must pay and determining where they have to go for care.

7. A ban on gag clauses that some hospitals include in their insurer contracts. Hospitals could no longer prevent patients or any other party from seeing all hospitals' cost and quality data.

8. Put a stop to "anti-tiering" or "anti-steering," where hospitals through their insurance contracts keep patients from choosing treatment at competing health systems.

9. There would be no more "all-or-nothing" clauses where hospitals force insurers to contract with all their facilities by saying if they don't contract with all of them they can't contract with any.

10. Hospitals could also no longer hide certain anti-competitive contract features from the employer plans they contract with.

11. The Government Accountability Office would be mandated to investigate profit-sharing between hospitals, contract management groups, specialty physicians and specialty physician contractors.

12. Dominant health plans would no longer be allowed to use their market leverage to hold local hospitals and physicians hostage for the best payment rates, to the detriment of competing companies.

13. Pharmacy benefit managers would have to send quarterly reports on the costs, fees and rebates to the employer plans they contract with.

14. Spread pricing of the rebates PBMs collect from manufacturers would be banned.

15. PBMs could no longer profit off health plans or patients by demanding higher drug prices than they paid the manufacturers, and they would have to pass along 100% of the manufacturer rebates or discounts to their plan sponsor.

16. Drug pricing, to stop manufacturer gaming of exclusivity periods and boosts for more generics and biologics.

17. Public health by seeking to boost vaccination rates.

18. Check the U.S.'s dismal maternal mortality rates. It also incorporates a number of health IT provisions.

The Rise of Faux Think Tank Research in the rubble left by Scott Walker and Trump!

Faux research and analysis now has market in Trump believers everywhere. The alternative world of resentful politics is expanding in Wisconsin. Thinking they were pretty damn smart, the GOP lawsuit mill Wisconsin Institute for Law & Liberty took their legal successes in front of right wing activist courts and decided to make even more money as a think tank pushing fake research and policy "ideas" that don't make any sense.

Unable to start, compete, and grow on their own, WILL in the beginning accepted a political special interest handout that made them a think tank arm of the right wing Bradley Foundation: 

With the help of a $500,000 grant from the Lynde and Harry Bradley Foundation, WILL launched as a law firm ... now includes research and advocacy arms and employs 18 attorneys, researchers, writers and other staff, plus two contracted advisers ... receiving a $1 million grant from the Bradley Foundation to launch its Center for Competitive Federalism. 

SEVEN REFORMS TO LOWER COSTS AND INCREASE ACCESS TO HEALTH CARE

Let's takes a look at WILL's "nibbling around the edges" ideas, that will do nothing to lower health care costs. Eventually, everything below would be exploited by insurers and the health care industry to increase profits on the sick and dying. My comments are in red:

1. Direct Primary Care – (DPC) offers one of the best avenues to cut out the costly insurance middlemen and allow patients and doctors to decide on care through transparent, up-front prices. In this system, clients pay a monthly fee to a DPC provider for the majority of their health services. 

Reality: This assumes you'll always be in the area where your DPC's are located. Seriously? 

2. Create a Dental Therapy License – The creation of a dental therapy license (less than a dentist but more than a dental hygienist) could increase access and lower the cost of routine dental care, particularly in rural Wisconsin where access to dental care is lacking.

Reality: Plain and simple, this lowers standards and care for the sake of lower prices. Yup, nice trade off there.

3. Free Speech in Medicine – Doctors and patients deserve to have all the information necessary when deciding care but the FDA prevents pharmaceutical companies from freely providing information on off-label uses of prescription drugs. 

Reality: For profiteers! This would allow drug companies to claim almost anything to sell more drugs, make more money. It also assumes doctors don't already know about off-label uses, which is just not true. 

4. Take full advantage of Short-Term Limited Duration Plans –The Affordable Care Act created uniform insurance regulations that eliminated much of the variety of insurance coverage. But not everyone needs, or even wants the same coverage. Short-term limited duration health plans are a flexible, low-cost alternative that consumers deserve access to. In some cases, these plans can be offered for 90 percent cheaper ...Wisconsin should match the federal government and allow consumers to purchase up to three years of coverage.

Reality: This brings back preexisting conditions, and if you get sick on your cheap insurance, get ready to payout that huge deductible first before any insurance payout. WILL is pushing what the industry calls JUNK POLICIES. What a "reform" plan.

5. Take full advantage of healthcare freedom in U.S. Territories –Other US states are subject to the same onerous restrictions as Wisconsin under Obamacare ... since 2014, US territories have been exempted from many of the more onerous parts of Obamacare ... Wisconsin citizens ought to be able to purchase those insurance plans if they happen to fit their needs.

Reality: "Freedom" and "Onerous restrictions?" Oh, you mean getting rid of mandating coverage for preexisting conditions? Last time I looked, Republicans copied the Democrats and ran on protecting preexisting conditions...until now of course. "Onerous."   

6. Reform Retroactive Eligibility for Medicaid – Controlling the cost of Medicaid without compromising care is critical. Wisconsin should remove any incentive for those eligible for Medicaid to avoid enrollment until after a medical procedure. Nearby states such as Iowa and Indiana received waivers from the federal government to implement this change. While this could potentially lead to a savings for the state—Iowa estimates it’s savings at $36 million in the first year—the more important reason is that enrollment could get people to the doctor sooner for more preventative care that could improve health outcomes.

Reality: This is intentionally cruel and a solution looking for problem. Let me understand this; people wait to get free BadgerCare until their sick, because...it's free? I can't wrap my head around this Republican "savings" on  the backs and lives of Wisconsinites. A WTF moment is there ever was one. 

A few Final Thoughts:

1. WILL pretends we didn't go through this all before the ACA became law. 

2. Cheap insurance reduces what insurance companies make...how long do you think they will stay cheap? I experience this in my 20's and 30's, and premiums skyrocketed and deductibles increased. 

3. Cheap insurance means everybody else with full coverage plans will pay more to make up difference. 

4. Nothing above actually lower insurance, or health care prices, or covers people who travel in state or out of state. 

5. Does nothing about increased high deductibles for employers either. 

Behold the GOP's Health Care Profit Driven Vision

It's time to take a look at the never-ending nightmare of GOP health care meddling, and how the U.S. system keeps picking the pockets of the Amercian people for their ghoulish bottom line. Hail corporate profits!

GOP ACA Repeal now based on GOP's own Axing of Individual Mandate: Can they get away with this? And get this; “Scott Walker, avowed Obamacare opponent, passes law to shore it up”: yet he also signed off on letting state AG Brad Schimel join the Texas lawsuit to repeal the ACA. Doh!!!

Twenty state attorneys general have filed a new lawsuit that — like the many lawsuits before it — aims to take down the Affordable Care Act ... The suit makes a new legal argument that relies on Congress's recent repeal of the individual mandate penalty. This lawsuit starts from Congress's recent decision to ax Obamacare's penalty for not carrying health insurance, reducing the fine from $695 to $0 — essentially getting rid of the provision.

In previous rulings, the brief argues, the Supreme Court has stated that this mandate is crucial to making the Affordable Care Act work. With the individual mandate penalty killed, the lawsuit argues that the entire law is no longer workable and ought to be struck down.

Or, as the lawsuit itself puts it: "Once the heart of the ACA—the individual mandate—is declared unconstitutional, the remainder of the ACA must also fall."

GOP's Medicare Advantage Con for Profit: The privatization of Medicare promoted through Medicare Advantage has gamed the system, costing $1 billion. This is the GOP's baby, and yet no one is shouting this from the mountaintop:

The U.S. Justice Department recently has been dealt heavy blows in its quest to recover millions in allegedly fraudulent Medicare Advantage payments to UnitedHealth Group. The federal government ditched most of its False Claims Act lawsuit. 

The federal government will only litigate whether the data used to secure more than $1 billion in Medicare Advantage payments was invalid. 

The Justice Department has opened several investigations into the upcoding practices in the Medicare Advantage program. UnitedHealth, Aetna, Health Net, Humana and Cigna's Bravo Health are all under federal scrutiny for potential upcoding issues. Risk scores were created to incentivize plans to cover all seniors ... several whistle-blower lawsuits in recent years that allege health plans have been inflating the scores to collect more funds. The lawsuit claimed UnitedHealth collected payments from false claims that it treated patients for conditions they didn't have, for more severe conditions than they had, conditions that had already been treated, or diagnoses that didn't meet the requirements for risk adjustment.

Insurer Denials to Treat Americans Back Again...: Without the ACA's built-in protections to provide Americans with complete health care coverage, insurers are already denying claims without even looking at them. It didn't take long, did it? Anyone see a problem?

Two leading Senate Democrats asked Aetna to hand over information about its prior authorization process, citing concerns that their practices may have violated federal law ... during a deposition that he never reviewed patient medical records when deciding whether to pay for treatment.

Wyden and Murray said Aetna's behavior in the California case "appears to violate safeguards put in place by the Affordable Care Act," which require insurers to allow beneficiaries to review their file.Aetna has acknowledged that six state regulators are looking into its prior authorization practices

The critique comes as congressional Democrats worry expansion of insurance plans that don't comply with Affordable Care Act coverage protections will lead to a higher number of similar cases. The Trump administration has lifted the time-limit on short-term plans, a move that critics say will pit these plans in direct competition with traditional insurance. "These junk plans skirt key consumer protections included in the Affordable Care Act that bar insurance companies from ignoring appeals, denying care or charging people more because of their age, gender, or because of a pre-existing condition," the senators' release said.

GOP's Rube Goldberg "Group" Insurance Plan to Raise Rates, Reduce Coverage and Promote Junk Policies: Nuff said...

As many as 4.3 million people are projected to leave the individual and small group insurance markets to enroll in association health plans over the next five years ... premiums in the ACA individual and small group would rise as much as 4% between 2018 and 2022, according to healthcare consulting firm Avalere Health ... projected that another 130,000 to 140,000 people would become uninsured in five years, compared to current law. 

The Trump administration in early January proposed a rule that would allow more small businesses and self-employed workers to band together to buy insurance under association health plans ... but many health policy experts have argued that association plans not required to offer the same benefits and consumer protections as ACA-compliant plans ... with fewer healthy members to balance out the cost of the sicker, older enrollees, Avalere said.

It's Back - That "Preexisting Condition" Killer Gets Trump Endorsement: It's called a "short-term" plan...that could last forever. Republicans are again, trying to separate the deserving healthy from the burdensome sick, just like Jesus would have done:

According to the proposed rule on short-term plans, plans that don't fully comply with the law's coverage mandates ... people can re-apply for these policies. They would not be automatically renewed since they would have to face screenings for chronic and pre-existing conditions. Should enrollees pass these underwriting screens, they could hold the short-term plans for as long as they want, which critics say pits these plans directly against traditional insurance. They also pose higher out-of-pocket costs for enrollees and some exclude coverage mandated by the ACA, such as maternity care ... do include annual coverage caps.

Going Back to our Future-Preventable Deaths Return with a Vengence: No, Health care was not better before the Affordable Care Act. In fact, it was a killer:

Little by little, the Trump administration is dismantling elements of the Affordable Care Act and creating a health care system that looks more like the one that preceded it. But some states don’t want to go back and are working to build it back up.

Congress and the Trump administration have reduced Obamacare outreach, weakened benefit requirements, repealed the unpopular individual insurance mandate and broadened opportunities for insurers to offer inexpensive but skimpy plans to more customers.

Last week, the administration released its latest proposal along these lines, by changing the definition of so-called short-term plans that don’t need to follow any of the Obamacare requirements, including popular rules that plans include a standard set of benefits, or cover people with pre-existing conditions. Taken together, experts say, the administration’s actions will tend to increase the price of health insurance that follows all the Affordable Care Act’s rules and increase the popularity of health plans that cover fewer services. The result could be divided markets, where healthier people buy lightly regulated plans that don’t cover much health care, lower earners get highly subsidized Obamacare — and sicker middle-class people face escalating costs for insurance with comprehensive benefits.

Rand Paul's group discount scheme: Single Premiums: $6,251 a year; Family Premiums $17,545 a year. Cheap?

Media Swings at Republican curve balls, and miss again: Just like the discussion around the Affordable Care Act, reporters and media pundits didn't know squat about health care, and that ignorance helped Republicans spread all the lies so many people believed today.

It's happening all over again, this time with Rand Paul's bizarre "group" health insurance idea. He wants every American to leave the individual insurance market and join a group association plan, pay their dues as a member (added cost), and get a similar group policy break that big businesses get. Sweet, it doesn't simplify buying insurance, it adds a whole new mind boggling level of bureaucracy.

What a deal...but there's a bigger problem.

The inconvenient truth #1; health insurance for employers is really really expensive too (according to Kaiser Family Foundation, 2015): 

This type of coverage is commonly called a “group health insurance plan” or “employer-sponsored health insurance.” In 2015, the average premium for single coverage is $521 per month, or $6,251 per year. The average premium for family coverage is $1,462 per month or $17,545 per year (source).Sep 28, 2015.

The inconvenient truth #2; worse still, group associations don't kick in the employer contribution side of the premium they normally give to employees:

On average, employers paid 83 percent of the premium, or $5,179 a year. Employees paid the remaining 17 percent, or $1,071 a year. For family coverage, the average policy totaled $17,545 a year with employers contributing, on average, 72 percent or $12,591. Employees paid the remaining 28 percent or $4,955 a year. Feb 16, 2016.

Group associations do no such thing, since they just provide a group buying discount for it's dues paying members. And then there are the high deductibles...etc.

The above figures are from 2015, and show pretty generous employee contributions. But the latest numbers from the Bureau of Labor Statistics show employers shifting their costs onto their employees ("Civilian" includes both private and government):

The fact is, Rand Paul is oblivious to previous attempts to do just what he thinks is the big solution:

A version of these self-insured association health plans first became widespread in the 1980s, but they failed in droves because many were undercapitalized. More troubling, these earlier association plans had a history of becoming what the Labor Department termed “scam artists” and the Government Accountability Office reported were “bogus entities [that] have exploited employers and individuals seeking affordable coverage.” More than two dozen states reported in 1992 that these early association plans had committed “fraud, embezzlement or other criminal law” violations.

The more ominous aspect of association health plans: market destabilization.People who don’t need to cover preexisting conditions or don’t want to pay community rates gravitate to the better deals offered by associations, leaving sicker people in the regulated markets. Naturally, regulated insurance prices increase as a result, sometimes causing a death spiral that crashes the market.

So Rand Paul really doesn't know what he's talking about, and yet, he sounds so confident. Note: Not one of the 2 morning show pundits asked about these two major points, which is why I didn't include them:

GOP health care so far: 22 million Lose Insurance, 20% Increase in Premiums, Insurers Leaving Individual Market. Nice!

There is no tweak, amendment, or new plan that will change the devastating impact of the GOP Trumpcare/Ryancare debacle. And today, the CBO confirmed to everyone that Trump and Trump alone controls the fate of the Affordable Care Act's Marketplaces.

Uncertainty has forced many insurers out of the individual market completely. In those markets where insurers pulled out completely, Republicans wrongly assumed no one else would step in and take their place, ignoring just how markets work. Doh!

The new CBO report offers up even more bad news for Republicans, including every American who's life depends on being insured.

If President Donald Trump stops cost-sharing reduction payments to insurers participating in the Affordable Care Act’s exchanges, premiums for individual plans would go up 20% on average, according to new analysis released on Tuesday by the Congressional Budget Office (CBO) and the Joint Committee on Taxation.

Trump himself has great power over whether the ACA survives, and one of the ways to help “Obamacare victims,” a term Trump and Vice President Mike Pence have used, is to guarantee these cost-sharing reduction payments to insurers, instead of threatening to stop them.

The Office’s findings underscore that Trump has control of the costs of these health insurance premiums. Many insurers that exited the marketplaces said they did so because of uncertainty over whether they would receive the cost-sharing payments.

“The most important thing that the president and the Republican senators can do is to ensure the funding for the cost-sharing reductions continues,” Dr. Mario Molina, former CEO of Molina Healthcare, told Yahoo Finance in July. “[Trump] has funded those on a month-to-month basis with no assurance they will continue. This is causing a lot of destabilization in the marketplace.”

For the insurers that have elected to stay on the exchanges to offer plans, many premiums were set in a similar ballpark to the CBO’s 20% as the insurers sought to hedge should the payments stop.

Republican Repeal and Replace schemes repeat of Failed Polices of the Past.

I've always thought of legislation as a show of values, especially the initial first draft, before saner heads prevail. And so it is again with another idea being floated by Sens. Bill Cassidy and Lindsey Graham. You know there's a problem right off the bat if "little dictator" Scott Walker signs off on the deal:

Imagine the governor holding each and every citizen hostage over their health care, that's what this means.

You’ll also notice in the Cassidy-Graham proposal below that if you are anything but a Republican living in a red state, you most certainly don’t count. You lost, winner take all, including your health insurance:

“We need to let states take care of themselves and give power back to patients,” Sen. Bill Cassidy (R-LA) wrote in a recent op-ed for the Washington Post. “Let a blue state do a blue thing and a red state such as mine take a different, conservative approach.”

The proposal would eliminate the subsidies for private insurance and end the Medicaid expansion ... marketplaces would no longer exist ... The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs. 

But this new Cassidy-Graham bill would not allow a state like California to keep the Affordable Care Act in place unless it wanted to kick in significantly more money. Here’s why:

1. The complex funding formula used to divvy up the big pot of money would tilt more funding toward sparsely populated states ... than those with denser, more urban populations.

2. It would also take the current Medicaid expansion spending from the 30 states that participate in the program and divvy it up among all 50 states. For a place like Texas, which has not expanded Medicaid, this would be a windfall ... but California would be dramatically disadvantaged.

3. Cassidy-Graham includes a requirement that insurance plans accept all applicants regardless of preexisting conditions. 

4. Ends the two policies: the mandate to purchase coverage and the tax subsidies to make coverage affordable ... little incentive for those who are relatively healthy to purchase plans. 

The key points; no mandate or incentives to be insured, and a requirement to accept preexisting conditions. As explained below, this is an old failed idea we may be doomed to repeat on a national level. This also proves historically that politicians in the House and Senate never had a clue about how average Americans got their health care coverage in the past, or for that matter, even now in the Marketplaces: 

States have experimented with this combination of policies before. In the 1990s, Washington state ended preexisting conditions without a mandate or subsidies. Seattle Times journalist Carol Ostrom recounted what happened next:

1. Without any leverage to bring healthy people onto insurance rolls, insurers, left with the priciest patients, began a financial death spiral.

2. Ultimately, companies pulled out of the individual market and almost no one in Washington could buy an individual policy for any price.

The Truth about Health Care GOP BS!!!

The simple truth about ObamaCare is this; it's a conservative, Heritage Foundation health care plan that includes over 100 Republican amendments. You can't get any more Republican than that! 

And yet the GOP has successfully sold the public on the idea that this is a liberal big government solution to a non-existent problem, forced on us by President Obama. The truth is, the CBO projections on both the House and Senate plans does two things; it tells us how bad their reform plans are, and most importantly, shines a light on how bad the free market version of health care will be, again.

Taxpayers on the Hook with High Risk Pools: Seriously, one of the biggest complaints by conservative voters is the idea their health care dollars would be used to pay for someone else's treatment. It drives me crazy. They must think their premium payments are being put aside for just them. So who pays for the insurance company employees and their wealthy CEO's?

Getting Rid of Health Insurance Completely: Why pay for insurance at all!!! Just automatically enroll sick people into the high risk pools, paid for by general tax revenue, and do away with the crazy idea of insurance for the healthy. Dumb Ron Johnson below is basically making that argument, but doesn't know it.  

Government Health Care Doesn't Work? Just the opposite, since every other industrialized country in the world has proved over and over that it does work. By the way, there isn't one example of a successful free market health care system anywhere. None.

Paul Ryan admits, Universal Health Care - Medicare for All Better Deal: He did, in a 2009 comment on ObamaCare, saying private insurers couldn't compete with the better government deal.

No more Town Halls for Ryan!!! Afraid and hiding from angry crowds, or protecting constituents from "a harassing environment?" Took High School students Questions in Advance?

Elected politicians are supposed to answer to their constituents. Not anymore out of fear and constituent anger over their agenda.

Scott Walker said he wanted to divide the public and destroy the unions, and did just that despite the outcry and anger of millions of Wisconsin protesters. Instead of moderating or acknowledging their existence, Walker said Wisconsinites were trying to intimidate him...seriously, who thinks like that?

So Walker no longer answers to the state voters because he's afraid to appear in public. He now appears only at closed corporate events.

Add House speaker and Wisconsin Rep. Paul Ryan to the list of frightened unreachable's. Ryan's excuse? He's protecting his constituents of course. Make no mistake, he's personally not afraid to defend his indefensible health care plan in an unpredictable town hall environment, like Scott Walker:

"It's not that I'm not doing town halls. I'm getting around to see constituents all the time. I'm doing office hours, I'm doing telephone town halls, I'm doing business interviews. I'm doing it in a way so constituents don't go into a harassing environment." -Ryan

Ryan attacked those out-of-state protesters, not the in state protesters. Reminder, Ryan's agenda affects all Americans, so in this case, out-of-state citizens showing up makes a lot of sense:

Ryan: "I'm doing it in a way so that constituents don't go into a harassing environment. So I want to make sure my constituents don't be agitated and walking into a harassing environment. I want to be able to interact with my constituents in a way that THEY feel comfortable as well." 

Meeting with constituents is a test of whether a politician doing their job or not. And if the pubic is angry, disruptive and asking pointed questions that can't be logically answered, well, that tells that elected official he or she is out of touch.

Oh, and it appears Ryan can't take heat from even high schoolers?

At Badger High School, Ryan, responding to questions that a school official said were submitted in advance...

ACA "Death Spiral" thanks to GOP/Trump repeal/replace Fumbling.

It's not the ACA exploding, it's the Trump administrations shoot from the hip health care debacle that's spooking the insurance horses. Remember, Republicans were once real big on whining about how "uncertainty" would destroy the economy...correction; health care.  

Uncertainty about what the Trump administration is doing with health care has already led insurers to increase costsHealth insurance companies are saying that no matter what happens with the Republican health-care bill in the coming months, premiums will go up in 2018 just from the uncertainty of the situation. "The health plans I work with want to stay in, but the Trump administration is not making that easy," insurance industry consultant Robert Laszewski explained to Vox.In one example, CareFirst, a BlueCross BlueShield plan in Maryland, Virginia, and Washington, D.C., submitted 2018 premiums last week that reflect hikes averaging between 39 and 52 percent depending on the state."Uncertainty breeds higher costs," New Mexico Health Connections chief executive Martin Hickey told Vox. "We have to plan for the worst case scenario until it finally gets decided."

Yup, right from the insurance industries mouth...

“We were hoping for more stability this year,” says Chet Burrell, chief executive of Carefirst, a Blue Cross Blue Shield Plan in the D.C. metro area. “But these factors have lead to instability, and the beginning of a death spiral.”

Burrell says that his plans would have had hikes this year anyway, because it has lost money during its three years on the Obamacare marketplaces. But it tacked an extra 15 percent onto its premiums because it does not expect the Trump administration to enforce the individual mandate.

“The current approach at the federal level has been to say they’re not going to enforce it,” he says. “We think the effect of that is to encourage healthy people not to enroll.”

Can't blame Obama: And he wasn't the only insurer:

Iowa could be left in a similar situation: 94 of its 99 counties are served by just one health plan, Medica, which is not committed to sticking with the marketplace in 2018.

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today,” the plan said in a statement to the Des Moines Register.

Two other insurance plans, Wellmark and Aetna, also quit the Iowa marketplace this year citing the law’s uncertain future.

Never forget Paul Ryan and the Republicans, who ‘‘gut Obamacare and rescued the American people!’’ Yeah, 24 Million will Lose Insurance, Taxpayers will Pay for the Sick.

Paul Ryan has finally passed a repeal of the Affordable Care Act, that will create taxpayer supported costly high risk pools and an exemption for states to dramatically reduce essential health care benefits. All of this on top of the CBO's original estimate that 24 million will eventually lose their insurance.

A real feather in Ryan's cap. Janesville must be embarrassed.

And because of the uncertainty created by Ryan's tea party House of Representatives, insurers did indeed start pulling out of the exchanges.

Ryan may want to blame ObamaCare, but the Iowa insurer who's pulling out of most counties in that state, blamed Ryan and the Republicans:

Medica, a Minnesota-based health insurer, released a statement suggesting it was close to following two larger carriers in deciding not to sell such policies in Iowa for 2018, due to instability in the market. The company’s statement said:

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today."

Save this video clip forever! When Americans start looking for someone to blame for this disaster filled with empty problems and absolute lies about lower premiums and lower deductibles, this happy clueless ghoul is your guy:



All the Republican details are Wrong: Check out the House announcement and analysis that trashes this irresponsible bill. Employer plans are also going to see reduced coverage and increased costs. Interesting to note: About half of all employees getting coverage have preexisting conditions, and 86% of 55 to 65 year old's have a preexisting condition - that's essentially half the population. That additional $8 billion means nothing:

It cuts the Medicaid program for low-income people and lets states impose work requirements on Medicaid recipients. It transforms Obama’s subsidies for millions buying insurance — largely based on people’s incomes and premium costs — into tax credits that rise with consumers’ ages. It would retain Obama’s requirement that family policies cover grown children until age 26.

But states could get federal waivers freeing insurers from other Obama coverage requirements. With waivers, insurers could charge people with pre-existing illnesses far higher rates than healthy customers, boost prices for older consumers to whatever they wish and ignore the mandate that they cover specified services like pregnancy care.

Here's the Trump Rose Garden chest thumping by Republicans that seem to think their bill was a good idea:

Republican Rep. Davidson compares buying Health Care to buying a flip phone: "We weren't endowed by our creator with health care..."

Health care is like a flip phone? And it's not like health care is endowed by our creator either. God just gave us life, after that, you're in the free market baby, cough up the cash or die. Just a few pearls of wisdom from Ohio Republican Rep. Warren Davidson:

Warren Davidson: "Lots of people don't believe in a free market, they want health care as if it were endowed by your creator for health care. (eliciting loud yes', exactly). We weren't, but we weren't. We weren't endowed by our creator with health care, we were endowed with life. So  you're not entitled to someone else's stuff. So in health care for example, we have to protect the free market."

Free markets were endowed by our creator? No wonder so many "pro-life" groups don't care about providing health care, no reason to save the "baby" after it's born. (check out Supply Side Jesus below)

Funny thing, constituents knew and groaned in reaction to Davidson's easily recognizable inhumanity.

I started the town hall video off with Davidson's big mistake about his own party's health care subsidies, based on age. He wrongly claimed it was based on income, you know means tested, like it is on the Affordable Care Act. And these guys are going to pass a national health care plan?:

Warren Davidson (R-Ohio) told the mother of a service industry worker who has benefitted from the Affordable Care Act’s Medicaid expansion that her son should get a better job if he wants decent insurance when Obamacare is repealed.  

Her grown son lacked health insurance for four years, because his job in the service industry did not provide it. He received coverage through Medicaid.

Constituent: “Can you explain why my son and millions of others in his situation are not deserving of affordable, decent health care that has essential benefits so that he can stay healthy and continue working?”

Davidson: “OK, I don’t know anything about your son, but as you described him, his skills are focused in an industry that doesn’t have the kind of options that you want him to have for health care. So, I don’t believe that these taxpayers here are entitled to give that to him. I believe he’s got the opportunity to go earn those health benefits” (eliciting boos from the crowd).  “If he doesn’t want a catastrophic care plan, don’t buy a catastrophic care plan. If you don’t want a flip-phone, don’t buy a flip-phone” (eliciting loud groans from the audience).

Constituent: “I’m sorry, health care is much different than a cell phone and I’m tired of people using cell phone analogies with health care.”  

Davidson’s metaphor resembled remarks by Rep. Jason Chaffetz (R-Utah), that people should not buy iPhones if they wanted the money to pay for health insurance.
Consumers do not have the same power to command lower prices for health care, since it is not a product they can choose to not have.

Before he was a Senator, Al Franken put this piece together:

Ryan's Unforgettable TrumpCare Failure!!!

As it turned out Freedom Caucus Tea Party Republicans, who wanted no real replacement to help Americans buy insurance, resulted in moderate Republicans voting no on Paul Ryan's TrumpCare monstrosity. Take note, every Wisconsin GOP Representative would have voted for the final version of this cruel inhumane joke.

The fact that Paul Ryan never came up with, or tried to put together, an agreeable GOP plan in seven years cannot be lost in all of this. TrumpCare finally exposed this self-righteous fraud.

Trump: "We will have so much winning if I get elected that you may get bored with the winning.”

Ryan Comment #1: "Moving from an opposition party to a governing party...?" No, really, you think?

Ryan Comment #2: "Are we willing to say yes to the good, the very good even if it's not the perfect?" 24 million losing their health care is "very good" and "not the perfect?" Like it's close, right?

Ryan Comment #3: "I'm really proud of the bill we produced. It would make a dramatic improvement in our health care system, and provide relief for people hurting under ObamaCare." My god what is wrong with this guy...see picture -----------------------------

Ryan Comment #4: "So I don't think the architects of ObamaCare...I'm sure they may be pleased right now,  but when they see how bad this thing gets...I don't think they're going to like that either." Sneaky. Ryan is promising not to lift a finger to fix the ACA in the future. And repeal still hangs over insurers, who may see no future in staying on the exchanges. That makes this the GOP's fault. Modern HealthCare:

Experts expect HHS Secretary Tom Price to try to pare down those mandates through rule-making. 

Insurers have complained that the huge uncertainty caused by the GOP effort to repeal and replace the ACA has made it difficult or impossible for them to make plan and rate decisions for 2018. Some say they're weighing whether to withdraw from the individual market. And that was before House Republicans and the White House last week unveiled their proposal to erase the ACA's minimum essential benefit requirements. “This is adding even more uncertainty to an already-uncertain situation, making it unlikely insurers would continue to participate,” said Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation.

Trump wont fix ACA, also set it up to die from uncertainty for insurers, and then blamed the Democrats? Here's Trump's promises, his failure and MSNBC's Joy Reid showing Democrats just how to drive the point home over and over again, never letting Republicans off the hook:

Changes proposed to attract additional Republican votes for the party’s bill will narrow the amount of deficit reduction by more than half, according to the nonpartisan CBO.

Many Republican governors were relieved they wouldn't have to make really really unpopular cuts:

The nonpartisan Kaiser Family Foundation found in a study this week that trying to maintain the existing levels of Medicaid coverage would have taken cuts equal to one-fourth of some state governments' education budgets to keep the coverage without raising taxes, the report found.

Trump Denied ever saying Repeal and Replace? Well....



NJ Democrat Frank Pallone nailed Republicans for voting yes...should have gotten more press:



Important Health Care Points:

There also were concerns that eliminating the federal benefit rules or delegating benefit determinations to the states could drive up premiums for people with chronic conditions. In addition, removing the essential benefits requirement would essentially neuter the ACA's ban on insurers setting annual and lifetime caps on benefits, since they could set limits on services that are not required benefits. Removing the basic benefits mandate also would make it harder for consumers to shop and compare plans.

Oops, Ad's thanked Republicans for ACA repeal! Premature victory laps are embarrassing enough, but don't be surprised if the GOP starts congratulating itself for not repealing the ACA...that's next:

Basketball fans in several Republican-adjacent TV markets are enjoying a series of ads, prematurely bought by the American Action Network PAC, inviting viewers to call their representatives to thank them for repealing Obamacare today—something that did not happen.

Ads praising Virginia’s Barbara Comstock; it ran during the Wizards-Nets game ... ads for Fresno’s David Valadao and Des Moines’s David Young; both ran on CBS stations before March Madness coverage. Money well-spent, we think.

Free Market Medicine: Hospitals to Prioritize, take Privately Insured over Medicare and Medicaid Patients.

TrumpCare/RyanCare is "free market" voodoo: The CBO analysis may have freaked Republicans out, but that bad news only scratching the surface. There are so many moving parts in health care, that it's like a game of whack-a-mole.

The GOP's "free market" voodoo gives insurers and hospitals unlimited control over 17.8 percent of the economy. With that much money on the line, what do you think will happen?

Profit over People: Hey, it's business:

Dr. John Noseworthy, the chief executive of the Mayo Clinic, recently told his employees that the prestigious health system will prioritize the care of privately insured patients over those on Medicare and Medicaid.

That's bad news for the massive number of baby boomers moving into Medicare.

That bold pronouncement reflects the growing unease among hospital executives who are watching profits shrink due to steady increases in the number of government-insured patients. Noseworthy said...

“We’re asking … if the patient has commercial insurance, or [if] they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year.” 

While we were concentrating on the huge number of people losing their insurance in the individual market, Medicare patients are getting pushed aside by hospitals as well:

“There is this thought that hospitals treat whoever comes to their door, but this is a statement that lays out what happens,” said Christine Spencer, a health economist at the University of Baltimore. “It’s a surprise to hear it out loud like that."

Hospital Power Play: This isn't a new concept either, and its created inflated insurance premiums in the past in regions where hospitals have monopoly power. 

The health system’s market power gives it the ability to charge more for its services and command high payments from commercial insurers, a clout it can’t wield with the federal government. So, in prioritizing those commercially insured patients, it is following the money.

According to Harold Miller, chief executive of the Center for Healthcare Quality and Payment Reform:

“It’s a very lucrative thing for them to do." While it makes sense from business perspective, it doesn’t help to solve the underlying problem of America’s sky-high medical costs. “True leadership would be to figure out how to deliver high-quality services at the lowest cost possible. If institutions are simply going to say, ‘I’m not going to serve patients unless I get paid more,’ that’s only contributing to the problem.”

While Republicans feign concern over the poor, and play them for saps by giving them a false sense of security with bare bones catastrophic junk insurance policies, hospitals are aiming for much higher:

The hunt for higher-paying patients plays out in all sorts of ways, experts said. A medical center may locate its satellite offices and target its advertising in wealthier suburbs. Hospitals might reduce emergency room services so they do not have to handle the chronic yet untreated issues — such as diabetes or high blood pressure — that regularly bring people without insurance to the hospital.

Regulation is another way of saying Protection: Word smith George Lakoff came up with this simple interpretation. Once I had a chance to absorb the concept, I immediately saw how it works for "free markets" and "social" programs.

In reality, government doesn't get out of the way in a free market system, it actually establishes regulations - or protections - that let businesses do things.  "Socialism" also provides regulation - protections - but for the public good. So which side do you want to protect more?    

Patient + Private Business = Doctor? What's wrong with this equation?

Republican rhetoric is filled with "buying" insurance, the one thing that has nothing to do with treating sick people or promote prevention.

So we're not asking the most obvious question; why are we inserting a for profit business between a doctor and their patient? Think about how odd that is. And yet Republicans think this is normal, a sign of freedom?  

Actually, Republicans are just defending freedom and liberty. It's that natural born God give freedom to buy things, or not buy things.

1. In Wisconsin, Scott Walker tried and failed to make protesters buy a license to protest.

2. That's why they supposedly hate corporate boycotts, because it's unfair and asks people not to buy things.

3. It also explains why money is speech, because it buys things. 

Their anger is all starting to make sense; not being able to buy big gulps, incandescent light bulbs, guns, and now...being forced to buy health insurance? Goodbye freedom and liberty.

24 million people may lose their ability to buy affordable health insurance, but that's not a Republican concern. What's really important is having the freedom and liberty to buy or not buy insurance. 

Or how about the freedom to raise money on your own to help pay your medical costs:

A GoFundMe page that aims to help the family has raised nearly $90,000 in less than three weeks. The money will be used to cover medical costs and efforts to help him adapt to life without appendages.

Car washes and bake sales anyone?

Insurers will have total control over the price of health care services, not the free market. NOTE: A single payer system, where we can see any doctor or go to any hospital, actually does create competition between providers, right? 

Where am I wrong here? Why have we plopped a for profit middle man between a doctor and their patient. Is this really the place for someone to make a profit?

Republicans Encouraged 24 million will lose Insurance.

Ghouls....

High Deductibles or Health Savings Account = Huge out-of-pocket costs under TrumpCare making Insurance unaffordable.

Not many reporters know enough about the ACA, or health care in general, but CNN's Bob Acosta does.

Sean Spicer scrambled at today's press briefing after getting peppered with legitimate questions and criticisms of the GOP health care plan and the CBO's devastating report.

Throughout the debate, Spicer continued to bash the ACA's high deductibles, clueless to the fact that the GOP plan leans on them heavily on them. They're called "Health Savings Accounts." HSA's don't automatically come with thousands of dollars in them. It's not a pot of gold at the end of Paul Ryan's rainbow. Americans everywhere will have to put the money in them, just like deductibles, cash they probably won't have. Again, it's no different than being stuck paying a high deductible. Spicer continues to use the words "product" and "buy" as well. Our health is not a product.



By the way, the White Houses Office of Management and Budget did project how many people would lose insurance, 26 million, more than the CBO. Spicer denied they did, "not something OMB does," at the end of the clip. He lied.

The Director of Office of Management and Budget, Mick Mulvaney, treated health savings accounts like they're already filled with money, that they are somehow completely different from high deductibles. You'd think he would know better. Both require out-of-pocket costs that make health insurance unaffordable. Note: The ACA also provided an extra subsidy to help low income families pay for deductibles and copays, dramatically reducing them:

Holy Crap, Republicans don't know anything about Health Care Insurance!!!

When it rains stupidity it pours stupidity.

Breaking News: America should be waking up to the idea that Republicans don't understand health care at all, or for that matter, how insurance works.

In a breathlessly stupid number of recent comments, we're supposed to put our faith in a Republican "the time is here, the time is now" remake of health care?  

It wasn't just the Rep. Jason Chaffetz's moment either (with a great response from former Mayor Gavin Newsom), add to it Rep. Roger Marshall, (R-Kan.) comments below, a first-term congressman who spent three decades as a physician and is a member of the GOP Doctors Caucus. He said:

“There is a group of people that just don’t want health care and aren’t going to take care of themselves. Just like homeless people... I think just morally, spiritually, socially just don’t want health care.”

“The Medicaid population, which is [on] a free credit card as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging; I’m just saying socially that’s where they are. So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [to] the ER." 

What, pregnancy has something to do with guys? It's still mind boggling to think that conservative men don't connect pregnancies to guys, and the resulting "prenatal care."

Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about Shimkus’s objections to the Affordable Care Act’s requirements for health-insurance plans. Doyle asked Shimkus,“What mandate in the Obamacare bill does he take issue with?”

Shimkus: “What about men having to purchase prenatal care?” 

At that point, one could hear the room start to stir.

Shimkus: “I’m just . . . is that not correct? And should they?”

Paul Ryan doesn't get Insurance? True!: After all these years, you'd think Ryan would at least know a little something about insurance, since he wants to hand all our health care needs over to them. But he doesn't. He wants the government/taxpayers to pay for the sick instead of insurers? He said the following like it was something bad. Scary, Ryan doesn't get it:

Ryan: "Young and healthy people are going to go into the market and pay for the older sicker people. So the young healthy person is going to be made to buy health care and they're going to be paying for the person who gets breast cancer in her 40's, or gets heart disease in his 50's...the people who are healthy, pay for the people who are sick. It's not working and that's why it's in a death spiral." 

That's how insurance works....what in gods name is this guy inhaling? No wonder this is all so screwed up:



No, the public should not pay for the sick so insurance companies can make hefty profits. Democrats...are you there?

University of New Hampshire's Stephen Pimpare, the author of "A People’s History of Poverty in America" and the forthcoming "Ghettos, Tramps, and Welfare Queens: Down and Out on the Silver Screen," summed up nicely exactly what ails the Republican Party and their envious resentful voters:

For people like Chaffetz or Paul Ryan, this stubborn insistence that people could have more money or more health care if only they wanted them more absolves the government of having to intervene and use its power on their behalf. In this way of thinking, reducing access to subsidized health insurance isn’t cruel; it’s responsible, a form of tough love in which people are forced to make good choices instead of bad ones. This is both patronizing and, of course, a gross misreading of the actual outcome of laws like these....The implication that we should be worried by the possibility of poor people buying the occasional steak, lottery ticket or, yes, even an iPhone...Set aside the fact that a better cut of meat may be more nutritious than a meal Chaffetz would approve of, or the fact that a smartphone may be your only access to email, job notices, benefit applications, school work and so on. Why do we begrudge people struggling to get by the occasional indulgence? Why do we so little value pleasure and joy? Why do we insist that if you are poor, you should also be miserable? Why do we require penitence?

Just because what Chaffetz is saying isn’t novel doesn’t mean it isn’t uninformed and dangerous. Chaffetz, Ryan and their compatriots offer us tough love without the love, made possible through their willful ignorance of (or utter disregard for) what life is actually like for so many Americans who do their very best against great odds and still, nonetheless, have little to show for it. Sometimes not even an iPhone.

TrumpCare Republicans know more than Medical Providers, Doctors, Hospital CEO's and Insurers!!!

Why didn't Democrats toss off tea party protesters as paid off lackey's of the Koch brothers who opposed the Affordable Care Act? 

Why didn't Democrats brush off complaints about climate change as the last gasps of industry special interests willing to say anything? 

Democrats never denounce anything or predict failure and disaster over pending Republican legislation. It actually gives everyone the impression Republicans have a legitimate argument to make.

TrumpCare Disaster: Now Republicans are slamming a huge swath of their voters; doctors!!! Doctors have been a big voting block for Republicans, but even they have had it with their parties attack on health care.

Republicans pushing the legislation are unfazed by the criticism, charging the groups are simply to seek to protect the benefits they received from the Affordable Care Act.

White House press secretary Sean Spicer on Wednesday pushed back, saying the legislation isn’t aimed at winning over special interests.

“We would love to have every group on board, but every single deal we heard about getting through [in ObamaCare] … over and over again, it was one deal after the other, to buy votes to get it through the Senate,” he said, in response to questions about criticism from the AMA and AARP.

“If you want to line up how many special interests that got paid off last time versus now, they’ll probably win, hands down. This isn’t about how many special interests in Washington we can get paid off, it’s about making sure that patients get the best deal that lowers prices.”

Many industry and patient groups are charging Republicans with the opposite: making care more expensive and harder to pay for, in addition to potentially taking away coverage from millions of Americans.

This didn't go over well. Modern Health Care:

The CEOs are impatient, especially after Trump's recent statement—which amused and alarmed many of them—that “nobody knew healthcare could be so complicated.”

Republicans aren't interested in getting input from every front line health care provider. That can't be good:

Of CEOs responding to the survey, 77.9% oppose repealing the ACA, even with the promise of a replacement plan and a transition period. And 79.2% favor keeping the law's expansion of Medicaid coverage to low-income adults, which would be eliminated or phased out in most Republican proposals. 

The Power Panel is mostly made up of leaders of large hospitals and health systems, including some that operate their own health plans. But the participants also include CEOs of insurers, suppliers and technology companies, as well as associations representing sectors across the industry.

That's not all:

1. Nearly two-thirds (65.4%) want to preserve generous premium subsidies so no one pays more than a set percentage of income for health insurance. That contrasts with the House GOP plan to base premium tax credits on age rather than income. 

2. About the same percentage prefers to keep the ACA's minimum essential benefits, which would be erased under Republican plans.

3. Just 2.6% want to kill the law's requirement that nearly everyone buy coverage, a prime target of the repeal effort.

Easy Paul Ryan Health Care Plan Fact Checking...He Lies!!!

Fact checking Paul Ryan could become a full time job for me.

1. Here's a few easy fact checks that anyone with a passing knowledge of health care would know. Paul Ryan says...:

“It repeals Obamacare's taxes. That's a trillion dollars in tax relief for families that will help them with the cost of health care.

Wow, wrong! Imagine tax relief for these families needing help paying the cost of health care: 

It "primarily affects high earners making over $200,000 as an individual or $250,000 as a family), large businesses making over $250,000 and those with 50 or more full-time equivalents, and the health care industry. There's a Medicare Tax on investment income; 3.8% over $200k/$250k.

Is that you, barely making ends meet? Please.

2. ObamaCare is paid for through the above taxes. When it spends, it does not create deficits. In fact it will cut the US debt in the future...kiss that goodbye. So is the following really a bragging point?: 

It repeals Obamacare spending: Medicaid expansion and the Obamacare subsidies.

3. Health care before the ACA was bankrupting our country because the uninsured seeking medical care made our monthly premiums every year skyrocket and hospitals lost billions. Now under the guise of "freedom and liberty" and the free market, we're going back to those days. Yes, the uninsured will make everybody's health care costs skyrocket: 

It repeals the Obamacare mandates on individuals and businesses.

4. Finally, Ryan's miracle "refundable tax credit," or just another way of saying the "Obama tax subsidy." They are exactly the same, no kidding. Ryan would have think he's just performed a miracle. It would be funny if it wasn't so intentionally deceptive...and a crown jewel at that:

Ryan described one aspect of the proposal, providing tax benefits to those who purchase insurance individually versus those who receive it through their job:

"It equalizes the tax treatment of health care. Tax credits for health insurance is something that we as health care conservative reformers have been working on for years. This has been the crown jewel of conservative health care reform, to equalize the tax treatment of health care so we can have a vibrant individual market to have a free market in health care."

Besides the immoral bankrupt nature of profiting off sick people who need care, which is inexcusable all by itself, this horrific dangerous killer plan will fail. And when it does, let's put Ryan's own words on his health care headstone:

“This is monumental, exciting, conservative reform that fixes these problems. This is what we've been dreaming about doing, and we know it's going to make a positive difference in people's lives in this country."