A good recapitulation of how the AHCA came to be what it is.

Most telling:

But in my view, the most galling lie was about Medicare.

Early in Obama's term, Democrats sought to implement a significant expansion of subsidized health insurance without growing the budget deficit, so they imposed substantial cuts to Medicare spending as part of the Affordable Care Act.

Republicans were outraged, and they made opposition to Medicare cuts the centerpiece of their (successful) 2010 campaign to retake the House of Representatives. When Paul Ryan ran on the Republican presidential ticket in 2012, he and his running mate promised to restore the cuts if elected, out of a desire to protect seniors.

But once Ryan was actually in a position to shape legislation on healthcare that might become law, he decided to leave the Medicare cuts in place, because he would rather have the money for tax cuts for rich people.

Here's my broken record contribution:  This is all a bunch of hooey.  There is no such thing as a healthcare policy that is affordable, because we are the only country in the world that is stupid enough to privatize healthcare.  Some things should not be chained to a profit motive, and the health of the taxpayers is one of them.  Capitalism doesn't care how profits are made, it just cares that they are made.  Profiting from healthcare is the same thing as profiting from human suffering.  Until costs are brought back down to earth, any discussion on the issue is nearly useless.  We need to be paying what other countries are paying, and receiving the superior service that they are receiving.  That will require a massive reboot of the system, which would likely induce an economic collapse.  We're fucked on healthcare, because we allowed it to fuck us.

I don't agree, Hal.

I have French healthcare, which is a mix of public and private insurance. Switzerland is entirely private. The UK is entirely public.

I believe there is just one, very simple, common element in successful systems: the insurers have no say in treatment. The insurer learns of a medical event when it receives an order (not "request") to pay. This eliminates a great deal of cost up-front: no more "prior agreement", no more lawsuits in case of disagreement, ... Since the insurer cannot limit their costs by limiting treatment, they are under pressure to do everything possible to reduce administrative costs - the French system is very nearly paper-less.

Obviously, there must be some way of controlling costs. I don't know about the other countries. In France the local equivalent of the AMA does the job. They measure the costs engendered by practitioners, and compare them to regional averages. If a practitioner goes significantly higher than the average, then s/he is asked to explain. The insurer, public or private, is not involved. Obviously, the medical association wants to do a good job at cost-control, so that all the other interested parties have no excuse to stick their noses in.

advisory

"According to prices reported to the federal government, a one-liter bag of normal saline costs about $1.07 to produce, up from $0.46 in 2010. However, Bernstein noticed major variation in what hospitals billed patients for the product while investigating a May 2012 outbreak of food poisoning that sickened more than 100 people in upstate New York.

Even though most of the patients received IVs from the same distributor, Bernstein writes that some of the bills varied significantly, even for patients in the same hospital, and included markups of "100 to 200 times the manufacturer's price, not counting separate charges for" administration."

That's from an article in 2013.  Do you think anything has changed in favor of the consumer by now?

Do you think anything has changed in favor of the consumer by now?

The statistics show that the rate of increase in healthcare costs has dropped since the arrival of Obamacare... but those costs are still going up.

As long as the insurers can, basically, do whatever they like, and send the bill to Uncle Sam... there will be abuse.

Capitalist companies exist for one reason only: to maximize shareholder results. It would be silly to expect a healthcare company to put the patient first; that is not their purpose.

here is no such thing as a healthcare policy that is affordable, because we are the only country in the world that is stupid enough to privatize healthcare.

AGREED! Health care as a for-profit commodity ought to be criminal … a racket.

Fundamentally... no "public service" (local or national) monopoly should be in private, for-profit hands, IMNAAHO. Water distribution? Air-traffic control? Tollroads? Internet?

Exactly. And until America can enter the 21st Century on universal health care, as has the top 20 nations in the world, the ACA is workable and doable. Come up with a universal, single payer system that will insure all, at the lowest premiums, and it will pass both houses of congress.

Don , I will go one better , do away with the bronze ,silver gold and Cadillac plans , make congress have  have the same coverage as the lowest being served and have to pay for it themselves and one would bet shit gets straightened out fast, and while we are at it , do away with that government retirement program ( nothing more than a golden parachute) , and make them have to depend on SS or their own IRA/ 401K no more congressional retirements , if they have been there over 10 years , they have been there too long, yes term limits .

I posted this response to another of bobs articles but it fits here as well, and I will add a few things at the bottom.

actually it doesn't matter if its the dem version or the rep version , there are still some very big flies in the ointment so to speak.

 and that's both insurance  and healthcare are both currently run as a for profit business, and before you can make ins that is actually affordable for the greatest majority , the cost of healthcare itself must be addressed and the only way to address both issues is to remove the for profit aspect from both industries , and make no mistake they are both SEPERATE industries  and from what I see , both plans only address one side and not the other, and from my view both those issues need addressed or nothing any side comes up with mandated to the people has a snowballs chance in hell of even coming close to working.

And I have my own ideas of how I think its going to have to be done.

 First healthcare for basic healthcare will have to be nationalized  and the government will be the one to set the prices and whats going to be covered not the drs , hospitals or clinics , that means the government will have to hire those people . as for ins , once healthcare is regulated as to costs , then the insurance aspect can be addressed and exactly what the risk pools will actually be .

 In other words , single provider/ single payer, any other way and your simply pissing in the wind and trying to figure out who is going to get robbed by only addressing a single part of the entire issue.

as an after thought reading this article , and the examples where mandated  healthcare coverage  is in place , none of the mentioned places uses the same forms of coverage  plans ( though they most likely do cover the same things ) they also separately do not deal with the same population numbers .

the predisessor of the dems ACA ( Romney care  in MA) had its stumbles but it did have an added advantage no one is considering , those that disagreed , were free to leave the borders of the state, to escape it , under the national ACA there is very limited escape without having to pay.

 I have more thoughts , but I think this enough to digest for now.

I'm all for making the health care industry Non-profit...  Have been for years.  There are currently 3 hospitals  sitting empty within 5 miles of my house.  Why build them if they don't allow people to stay in them, and when they do stay in them, they can't pay for the care they receive?  

I don't blame the dems or the repubs, I think all the profit makers are at fault.  Up and down the board...  It's not, to me, anyway, a political issue, it's a moral issue.  We've got to stop seeing sick people as profit centers!

Mark, Dowser... 

I agree with you both. 

I would add that there's something morally... dubious... about profiting from others' ill health. 

But I don't know how to get there from here. Health is BIG BUSINESS. HMOs and insurers have bottomless funds to protect their monopoly on your health... Pragmatically, I don't see a path from here to there. I'd love to be wrong. 

I wish I knew the answer, Bob.  Maybe a reset back to 1965?  Perhaps it would be a start?  All the non-profit hospitals were still up and running, etc., back then.

I'm certainly open to ideas!

All the rules favor the wealthy. As long as that remains true, there's no solution to any particular problem. 

Ky hospitals: Obamacare forcing cuts, layoffs

LEXINGTON, Ky. – While Kentucky has gained national prominence as the only Southern state to fully embrace Obamacare, its hospitals say the law has left them facing billions of dollars in cuts and forced them to lay off staff, shut down services and worry for their financial health, and in some cases, survival.

The Kentucky Hospital Association outlined its concerns in a report released Friday called "Code Blue," saying payment cuts to hospitals are expected to reach nearly $7 billion through 2024. "Kentucky hospitals will lose more money under the Affordable Care Act than they gain in revenue from expanded coverage ," it said, experiencing a net loss of $1 billion by 2020.

"This report provides the real picture of what our hospitals are facing," association President Mike Rust said during a news conference at the Lexington Convention Center, where the group was holding its annual convention. While the Medicaid expansion has given many residents health coverage that has brought new money into hospitals, "the rest of the story is the cuts."

Hospitals are suffering a net loss, officials said, partly because about three-quarters of newly insured Kentuckians signed up for Medicaid, which reimburses hospitals less than it costs to treat patients. Nationally, the Congressional Budget Office projected half of newly insured patients would have private insurance. But Kentucky is a poor state, so most people who signed up for Obamacare have qualified for expanded Medicaid, which covers those earning less than 138 percent of the federal poverty level, or about $33,000 for a family of four.

Meanwhile, state health officials, and Gov. Steve Beshear, continue to tout the benefits of the ACA — including the state's decision to expand Medicaid. More than half a million Kentuckians got coverage through the state's insurance exchange, called kynect.

A February report prepared for the state said Kentucky hospitals had received $506 million more in Medicaid reimbursement since January 2014 because of the Medicaid expansion. That study also said the Medicaid expansion generated more than 12,000 new jobs in health care and related fields.

Beshear said in a statement Friday that the new Medicaid payments have blunted the impact of other financial pressures on hospitals. "We are very aware of the challenges that medical providers face in Kentucky," the governor said. "Rather than trying to turn back the clock and return to old business practices, we are working directly with providers to help them develop new strategies for better, more efficient, quality health care delivery."

Hospital officials say they're glad so many Kentuckians have gotten coverage through the ACA. A Gallup poll shows the number of uninsured Kentuckians dropped from 20.4 percent in 2013 to 11.9 percent by mid-2014, the second-biggest decline in the nation, after Arkansas.

But the association report says: "While Kentuckians should be proud of this achievement, it is also important to understand another part of the story: The government's success in expanding health coverage has come at a significant cost to Kentucky hospitals."

More financial stress

Hospital officials acknowledged that some of the issues, such as low reimbursements from government insurance, existed before health reform, but say they have only gotten worse since it went into effect.

"There's no question it's been accelerated under the ACA," said Dennis Johnson, president and CEO of Hardin Memorial Health in Elizabethtown, Ky.

The association's report says Obamacare has cut the number of uninsured Kentuckians almost in half but also cuts Medicaid and Medicare payments to hospitals by $4.6 billion from 2010 to 2024 to help pay for this expanded coverage. Medicaid now pays 82 percent of the actual cost of treating patients, while Medicare pays 86 percent.

The ACA also calls for reducing Medicare payments to hospitals that re-admit patients within 30 days at higher-than-expected rates and those with increases in their rates of hospital-acquired conditions. And it brings substantial cuts in "disproportionate share hospital" payments for uncompensated care. At $4.6 billion, these comprise the largest share of total federal payment cuts through 2024 of $6.98 billion to Kentucky hospitals. (These also include bad debt cuts, legislative and regulatory coding cuts and across-the-board federal cuts called sequestration.)

The changing way patients get coverage under the ACA also hurts hospitals, the report says. About one in five hospital patients who recently signed up for Medicaid previously had private health insurance, which reimbursed at higher rates, officials said. Meanwhile, many patients with job-based private insurance, and plans purchased on the state exchange, face high deductibles and co-pays. When they can't pay their bills, a hospital's bad debt grows. The association's report says this pushes up uncompensated care, even as charity care to the uninsured drops.

Altogether, the report says, rising bad debt and low government reimbursements counter any gains from increased coverage. Even though hospitals are getting $506 million more in Medicaid payments, officials said, it costs $617 million to provide care to those patients.

Responding to pressures

Complicating matters, the report says hospitals continue to face problems with Medicaid managed care organizations, or MCOs, such as slow payments, reduced reimbursements and denials of services.

"In my little humble opinion, they're only managing money. They're not managing care," said Charles Lovell Jr., CEO of Caldwell Medical Center in Princeton, Ky.

Mark B. Carter, CEO of the Louisville-based MCO Passport Health Plan, said state contracts drive what they pay to providers. He acknowledged payments from MCOs used to be slower but said they've gotten better in recent years. And he said his company only wants to deny claims that are inappropriate or fraudulent.

Meanwhile, hospitals are making significant cuts. More than 65 percent of 109 hospitals responding to a September Kentucky Hospital Association survey reported they reduced staff, cutting more than 7,700 positions through layoffs, attrition and abolishing positions.

"Some Kentucky hospitals have had no choice but to reduce staff to keep their doors open," said Lovell, adding that this is the third year his employees haven't gotten raises.

More than four in 10 hospitals reported service reductions, such as closing a sleep lab, a wound care clinic and a surgery department. And two Kentucky hospitals have recently reported they've had to close their doors for good. Rural hospitals have suffered most. A recent state audit showed that 68 percent of Kentucky's rural hospitals scored below the national average on a measure of financial strength looking at such figures as profit margin and cash on hand.

The hospital group proposes some solutions, such as standardizing policies and procedures across the various Medicaid managed care organizations and allowing health care providers to appeal denials that resulted in no payments. Rust said his organization also plans to continue measuring the financial health of hospitals and that "Code Blue" is going to be an ongoing project.

Beshear said he plans to continue working with hospitals, and a federal grant has allowed the state to hold meetings to share the best national practices and design strategies. "We're proud of the progress Kentucky is making in health care and will continue to support our medical providers as they navigate the changing health landscape."

~Link~

And yet, Norton Health Care just hired 200 more people, one of whom was my husband's secretary-- who could make better money and have better benefits than he could pay her...  Somehow, I don't think this is the full picture.

My hometown of Owensboro has a brand new, 3 year old hospital, and it seems to be doing just fine...  Financially, I mean.  Medically, it sucks.

lady d , I have been thinking about your post about the 3 empty hospitals , are they shuttered ? or are they open but just no one is using them ? I can see the cost aspect being high if they are open and get very little use.

 a lot of times such infrastructure is planned and built on projected growth , things that the planners THINK will happen in the future, but that's a funny thing , those plans and buildings can be wasted if that growth fails to happen and it can happen for any reason , look at the housing bubble burst , and how many neighborhoods throughout the country were basically left ghost towns , the growth didn't happen , the people moved to other places , the economy tanks and people go somewhere else , it can be any number of things or a combination of them that resulted in what your seeing .

looks to me like something like that , a shuttered hosp , could be acquired by the county , the county could do as I suggested and pay off some med students loans for a set length of service to the area as well as a pay check and housing same for a nursing staff, a community paid and supported hosp , along the lines I outlined and the thing is you can look at all the different models from around the world to see what actually works and what doesn't to lower the overall costs, it just takes someone somewhere to give it a try. if it sounds familiar , think of the TV show northern exposure, same plot premise.

They are open, but empty.  One has a Cancer treatment center on the bottom floor, but that's it.  Lights are on, but the building is empty.  One is owned by Baptist East, and they've put an Urgent Care Center there, but it is only open for a few hours a day-- if you need urgent care, you'd better need it in the afternoon.  Not open in the mornings or evenings.  Only one physician on staff.  VERY difficult to get to.  You can see it plainly from the interstate, but trying to get to the actual office requires driving through several parking lots.  Again, all the lights are on, but nobody is home.  The third one is owned by Jewish Hospital-- all lit up and shows no furnishings, no cars in the lot, etc.

Does that help?  It REALLY bugs me, to no end...  They have been "open" for several years now, but no one is there...

sounds to me like they were expecting a population growth in the area to sustain them that didn't happen , and what they turned into by keeping them open somewhat is a huge tax write off both with the state and the feds , if its loosing money it can be written off.

Yep.  It is very disgusting to drive by a state-of-the-art health care facility that is empty of furniture, etc., but all lit up.

"First healthcare for basic healthcare will have to be nationalized  and the government will be the one to set the prices and whats going to be covered not the drs , hospitals or clinics , that means the government will have to hire those people ."

I can only imagine the outcries of tyranny coming from conservatives over such a move.  You can't deny that.  They want government out of everything, and what you are referring to would amount to a government that goes from being an observer to absolutely ruling over an extremely lucrative private industry.

We did this to ourselves.  It is part of the American cultural landscape that doctors are deservingly wealthy, because they spend a ton of money and time on their education, and must shoulder outrageous malpractice insurance premiums.  They have solidified their position near the top of the food chain, and there's no way they will accept any attempt to take away their freedom to maximize their profits however they see fit.  Though insurance providers do fight back by setting limits on what doctors/labs/pharmaceutical companies may charge, if you are uninsured you are at their mercy - and that is to say you are powerless to fight the obscene financial raping they have in store for you for something as simple as an aspirin pill or bag of saline at a hospital.

We allow private ownership of... anything. I can own your health. You can own the water I drink. 

It's obscene. 

Capitalism without responsibility...  NOT a good thing!

well Hal , I can think of a way to sell it to a conservative , though I think its the progressive liberals that might get their shorts in a wad on a raw hemeroid.

One way I can think to sell it would be to use all those medical students that have outstanding government funded student loans , have then do a predetermined amount of time( service ) while being paid , say on a military type scale, for repayment relief for the loans they took, not any different than the free medical I got for signing the check cashable up to and including my life when I actually enlisted. of course they can still pay with cash , but I am sure a loan contract would be drawn up in either case. the needed service is provided , the loan is repayed to the nations benefit , I would call that a win win , but some would say that is indentured servitude, I disagree if they are being paid the median income that keeps them above the poverty limit, as opposed to possably being below it trying to simply repay the loans with money.

 other way I can think to sell it , the government buys in bulk , thus lowering costs be it supplies or equipment, way to stay a preferred vendor is to supply whats needed at the lowest cost , passed on to the individual in the way of priemiums , thus controlling and making things actually affordable.

 As for other things such as what would actually be covered , that remains to be discussed . personally I think similar risks should be pooled together ,  Take me for example , I am soon to be 55,  so basic wellness is a concern , vision , dental and coverage for accident would be all I really need  for now , I am single , but though I fall in an age group that COULD possably get someone pregnant , I cant , the plumbing has been disconnected from the municipal pool so why should I carry coverage for  risk I don't have nor contribute to? so what actual risk pool someone is in will have to be discussed as to how one is covered, and that's just one issue scripts , mental health and other things should all be dictated by the actual risk , I have a greater risk for lung cancer , than I do a mental breakdown.

 There even end up having to e a hybrid type system where an individual would be able to purchase riders to cover things that a basic NHC might not cover at all or might have to cap how much they would actually pay out even with their price controls in place.

 I think I was Blue , who mentioned talking to an ins agent saying doingaway with the individual mandate would screw the companies under the rep plan , that's only partially true , the other part is the real screwing came in the beginning with the pre existing condition clause , by removing the companies ability to manage the expected pool ( keep in mind it is still for profit) the only choice a company has even with the individual mandate , is to lose money or just get out of the marketplace , and we have seen many just opt for the latter leaving those that remain getting the slack and pricing the service as they see fit to cover the costs, in otherwords a monopoly is and has been created. and add to it the healthy people needed are opting not to participate . and there are other things there at play as well.

The House of Representatives has delayed a scheduled Thursday vote on proposed national health care reform, dealing a sharp blow to President  Donald Trump  and House Speaker Paul Ryan.

The landmark deal to replace former President  Barack Obama 's signature  Affordable Care Act  fell apart when the right-leaning House Freedom Caucus put up a fight over certain coverage measures remaining in the bill.

The House could return to vote on the health bill Friday.

The Republicans are fucked with this POS bill in several ways.

1) If it dies and goes away leaving Obamacare in place and allowing Democrats to jump in with their improvements … INCLUDING A SINGLE PAYER PUBLIC OPTION

2) If the bill passes the House and dies in the Senate

3) If Trump tweets invectives at House Members who were "NO" votes and caused the "delay"

4) If Trump publicly blames Ryan and Ryan publicly blames Trump and the House caucuses blame each other

5) If Trump blames Democrats AND REPUBLICAN TOWN HALLS ERUPT WITH CHEERS FOR THE DEMOCRATS FOR "SAVING OBAMACARE and THEIR HEALTH INSURANCE"

Republicans … be careful what you wish for.

Who are the snowflakes now?

TrRyanCare should have tried to care about constituents. Not that that would have mattered, since many of them just want to eliminate 'entitlements' all together.

I guess they didn't know that health care was so complicated.

I don't know what difference one more day will make. Yesterday to today didn't seem to make much difference. 

They should give it a month. Maybe Trump will go nuts by then and be committed to some sort of home. 

personally I would rather them not pass what the Republicans came up with , and if my hunch is correct , it wont pass , but a later bill will strip both the individual mandate and the fine for not having coverage  from the law .

a later bill will strip both the individual mandate and the fine for not having coverage  from the law .

Which means those without insurance will go to the ER and those who purchase insurance will pay an additional $1100/year more in premiums to cover the ER shortfalls.

The only viable answer is Single Payer. As long as the profit motive is in play, legislative whores will be owned by insurers, pharmaceutical companies, medical device manufacturers and sales lobbyists … it's not as complicated when you kick out the profiteers.

I believe you have been seeing me argue that already , with a couple other ideas thrown in to boot. but personally I think that's all the ACA was meant to do in the first place , just be a stepping stone to single payer/provider, it just took time for folks to get use to the idea.

I think that's all the ACA was meant to do in the first place , just be a stepping stone to single payer/provider, it just took time for folks to get use to the idea.

And I was unhappy that Obama never pushed the Public Option … so, we more or less agree.

A Mac , I also have another idea , but it might only work in a metro /urban setting , but it falls down to the premise of what level of government would end up being the single payer/provider. and I state it that way because providers and payers both are equal parts of the problem when profit is involved, so bear with me please.

 for the sake of argument I'm going to pick on john , and I invite him here to join the discussion for his thoughts about what I am going to propose.

 Chicago has upwards of 9 million residents unless I am mistaken but lets say that's accurate , what is to stop the city government from  collecting , say $10 per month per person  that reside in the burrows and precincts of the city proper, Not an exorbitant amount really. and each person is given something like the AARP card identifying them as a city resident. now by my math , that's 90 million $ per month, keep in mind that hosp operating costs will have to come out of that monthly figure, and if they want to keep ER's strictly for emergency cases  and not used as a primary care facility( which by law an ER can refuse treatment for non emergency /life threatening care at triage) some sort of secondary care clinic might need to be created for those things that fall in that category especially men when they get the flu and swear they are dying.....

The problem I have is when ever the feds get involved , their track record with money , frankly sucks, the states , eeeeh . the lower down and more answerable to the people actually being treated , that's where things can be accomplished, so in a metro/urban area , city or county government, those officials the people see every day and can hold their feet to the fire.

 and that's basically it without going too far into details that could be discussed , now I know what would have to be known is what generally are the medical operating costs per month , (without profit) that would dictate what the over all monthy cost would be , those being treated for emergencies from outside the preset boundries of the city would pay simple costs where as those paying the monthly  fee would not be charged.

 AAAAAAND let the discussion begin, workable? could it be tweeked?

what is to stop the city government from  collecting , say $10 per month per person  that reside in the burrows and precincts of the city proper, Not an exorbitant amount really. and each person is given something like the AARP card identifying them as a city resident. now by my math , that's 90 million $ per month,

Isn't that Single Payer on a small, local scale? I agree with the basic premise, but, on a National scale the pool is larger and the demographics broader. I'm not saying that $10/month x 12 months is a huge premium, but rather than a "flat tax" so-to-speak, a graduated premium based on a number of factors might be more equitable … in addition to the larger pool.

I could even envision small rebates for recipients whose claims fell below a certain threshold across, let's say, a three-year period.

But let's keep discussing this … maybe someone in government might stumble across our common sense.

That is EXACTLY what it is , but its kept at the lowest governmental control possible, and the reason I say keep it local, is the constitution itself , it defines exactly what powers are granted to the different branches of the federal government , if its not granted to the feds , it is retained to the states and the people respectively, the question of IF the federal government actually has the power and authority  that's not specifically listed , is already retained by both the state and the people. ( 10th amendment) that's why there is no national requirement for auto or homeowners insurance , the states regulate and make that set of laws of what is required .

 Now nothing says once a state or a city impliments something like this they cannot partner with the federal entity, to take advantage of the purchase power of the federal government for further cost savings.

 as for the graduated scale , that would be a hard sell because  some people will feel its just a hand out , whereas, if its per head, everyone actually gets to say they contributed the full amount, and as for rebates , I don't think that would be a good idea  because the whole premise is to get the for profit aspect out of primary  healthcare , so there would be no profits to rebate back .

remember , I have always claimed to be a fiscal conservative, and socially liberal dependant on the situation and subject, I am just putting forth a possible way to get things done that actually could turn into something benefitial , and this is what I came up with.

 it defines exactly what powers are granted to the different branches of the federal government , if its not granted to the feds , it is retained to the states and the people respectively, the question of IF the federal government actually has the power and authority  that's not specifically listed , is already retained by both the state and the people. 

The  Commerce Clause  describes an  enumerated power  listed in the  United States Constitution  ( Article I, Section 8, Clause 3 ). The clause states that the  United States Congress  shall have power "To regulate  Commerce  with foreign Nations, and among the several States, and with the Indian Tribes." Courts and commentators have tended to discuss each of these three areas of commerce as a separate power granted to Congress. ^[1]  It is common to see the individual components of the Commerce Clause referred to under specific terms: The  Foreign Commerce Clause , the  Interstate Commerce Clause , ^[2]  and the  Indian Commerce Clause .

The  United States Constitution  contains two references to "the General Welfare", one occurring in the  Preamble  and the other in the  Taxing and Spending Clause . The  U.S. Supreme Court  has held the mention of the clause in the Preamble to the U.S. Constitution "has never been regarded as the source of any substantive power conferred on the Government of the United States or on any of its Departments." ^{[3] [4]}

and where does it say , the federal government has the power to make an individual purchase anything from a 3rd party? that power is not granted nor do they have the power to grant it to themselves in laws , but under the 10th , the states and lower forms of government ( the people)  do.

and where does it say , the federal government has the power to make an individual purchase anything from a 3rd party? that power is not granted nor do they have the power to grant it to themselves in laws , but under the 10th , the states and lower forms of government ( the people)  do.

 

 

 

 

 

Supreme Court upholds Obamacare subsidies 01:19

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote in the majority opinion. "If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote in the majority opinion. "If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."

not the argument though, no one at least not I , has said the federal government couldn't offer a tax credit to those qualifying people to purchase HC , and that is what the decision upheld , that the government could offer those subsities.. nothing was said about someone choosing not to purchase ins , and not use the subsities , remember the subsities were granted based on income , not means (meaning what one might have saved over the years, or have acsess to to spend) technically a person could have over a million in assets and cash , but have absolutely zero  or such little income they don't have to file taxes on it, thus qualifying through other programs for coverage  acceptable to the ACA at little to absolutely no cost. and if its something they offer for free unasked for , who wouldn't take it?

as for the subsities helping? well there are less companies in the market place offering policies and they are more expensive , which is what I base my belief the ACA was but a stepping stone  to what we actually are discussing single payer/provider , and how to feasibly get it to come about.

In the absence of Single Payer, unless receiving health Insurance through an employer, how else but through a third party could it be acquired?

No question that the cart-before-the-horse aspect was side stepped … but there is still the General Welfare Clause …

… the General Welfare Clause is not a grant of general legislative power, ^{[5] [7]} but a qualification on the taxing power ^{[5] [8] [9]}  which includes within it a federal power to spend federal revenues on matters of general interest to the federal government. ^{[5] [10] [11]}  

I would contend that the ACA rests heavily on that.

But ultimately, whether via a city, state or other government entity, the Single Payer concept solves the complexities generated by the profit motive.

I would say we are in agreement on most points , it might be just a difference in wording and where the power actually lies , but the single provider( I doubt you will get the for profit private providers to agree with the prices paid for non profit) so the provider portion would have to be created as well as the payer portion be taken over as well , that's the only way I see to get the for profit out of the equation and that is a very big issue that contributes to HC costs, like I stated in another post , there may have to be a hybrid of private for profit and single payer/provider for a while , that both cover different things. but that is another discussion entirely.

… the General Welfare Clause is not a grant of general legislative power, ^{[5] [7]} but a qualification on the taxing power ^{[5] [8] [9]}  which includes within it a federal power to spend federal revenues on matters of general interest to the federal government. ^{[5] [10] [11]}  

I would contend that the ACA rests heavily on that.

I am certainly not an attorney, much less a Constitutional one, but it seems to me that it would cover nationalized, single payer healthcare. Certainly it does promote the general welfare.

randy that's an argument I will say isn't really relevant at this point since we are discussing how to make single payer/provider a feasible option, and we haven't even discussed what all would be covered under such a program . though I will admit this , the general welfare clause COULD be used for primary preventative care coverage as a means to fund that aspect of the program.

 so in essence we agree in principle , just how far is yet to be seen , and as AMac hoped , maybe some government schmuck will read this and see the common sense of it and take some of it to the table.

I do think we agree. I also think that there is no doubt that it would of course be challenged all of the way to the SCOTUS for a ruling on if promoting the general welfare is actually a basis for support of anything, even something it would seem as obvious as it would apply the health care. I can think of few things that would promote the general welfare more then healthcare. There are many who already argue that since it's in the preamble it can not be used as a basis for any law. To me it seems to be commonsense that that the Founding Fathers put it there for a reason and that reason is for it to be used, to be understood as a reason for the very founding of our nation, preamble or not.

and to that end we have to figure out what the founders were meaning when they used the term, I have heard it refurred to the post roads and public libraries , schools and things like that , I have also heard that it could have been meant to be used for general sanitation to avoid endemic and plague or to be used so that trade between the states went smoothly and no state could highjack another state by either withholding or charging exorbitant tolls and fees , but that gets into an origionalist and textualist debate, and how those would be effected in todays world.

and I have to agree , some squirrel nutted nose breather with a whistle most likely would take whatever we discussed and agreed about to the USSC protesting it.

In more than one arbitration in which I was involved, a decision came down to what a particular contract clause "said," as opposed to what it "meant".

A clause that stipulates the "General Welfare" is stated as such, unambiguously.

Since the Preamble cites the promotion of the general welfare as a primary reason for the very creation of the Constitution, it could easily be taken literally ... unambiguously. General (not specialized or limited in range of subject, application, activity), Welfare (the health, happiness, and fortunes of a person or group).

IMO, that which benefits citizens specifically, namely, good health in this case, thus benefits, in general, the welfare of the nation of those citizens.

Unfortunately arguing about what the Founding Father meant about anything in the Constitution document itself and the Bill of Rights has become a sort of cottage industry. People research other writings of the Founding Fathers, but they seem to cherry pick some writings such as letters or portions of diaries that backs up what they wanted their point to mean in the first place. IF it come up in front of a Supreme Court that is dominated by true original-ists and not Justices that just pay lip service to it, I would hope they would have see the Preamble as a valid part of the Constitution itself, with real meaning in law or otherwise why would it be so specific.

LOL again I do have to agree with both of you , but I would if I get into this discussion have to point out the precursor word , promotes , and its followed by provides for the common defense , what if promotes and provides had been switched so its provides for the general welfare , and promotes the common defense? see how the choice of the words can change the entire direction of the meaning?

what if promotes and provides had been switched so its provides for the general welfare , and promotes the common defense? see how the choice of the words can change the entire direction of the meaning?

"What ifs" are generally met with, "Objection, your honor, the prosecution is engaging in speculation."

The only two definitive words are General and Welfare … but I know their application has been and will be argued ad infinitum.

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

I guess I could see how some people could say that it could be a part of a "common defence (as they spelled it). That said that fact that all of the conditions in the Preamble are separated by commas makes me believe that the argument is stronger that they are meant to be taken individually. Of course as I have said I am not an attorney.

As an aside I would like to say that intelligent discussions like this, with no garbage are part of the reason I joined NT. Thank you.

Not with the comma ... That makes them separate entities.

I agree. The commas make them separate statements. Separate entities. Which is why I believe that "Promote the general welfare", is completely separate from the others and as I said I can't think of anything that promotes the general welfare more then the health of the nation's citizens. Healthy, well fed citizens make us a strong country. Certainly better then diseased and hungry citizen does.

yes my esteemed friend and what if frogs had wings? they wouldn't bump their ass when they hopped.

OBJECTION!!!!!!

 point is the founders chose their words very carefully for the constitution , to replace the weaknesses they saw in the articles of confederation , and they also in my view used very plain and understandable language of the time so that if read to an illiterate person that they could understand the meanings even if they could not actually read the words.

I think that is a policy that should be revisited in writing laws , instead of the lawyers legalese that has permiated government for so long thus needing an advanced English and latin degree to decifier whats being said.

randy , I pretty much stopped coming round after the election because of the virtrol from all sides , I would read some posts without signing in or commenting , to me it just wasn't and isn't worth the aggravation  of the pointless attacks and accusations, I will say I have enjoyed this discussion with both you and AMac on the subject, and the open minds we all I think are using in discussing it. thank you both.

I agree. In interpreting the Constitution many times lawyers and judges twist and turn themselves into knots trying to understand what the Founding Fathers meant, when if they would just stop that and just take a look in plain English at the document the meaning is right there in front of their eyes. In many ways it must keep up with the times and I believe it is a living document, but that doesn't change the fact that it is written in plain English and meant to be understood.

Which means those without insurance will go to the ER and those who purchase insurance will pay an additional $1100/year more in premiums to cover the ER shortfalls.

The only viable answer is Single Payer.

Absolutely. If this abomination passes, first of all it won't make it through the Senate, but if it somehow did and became law then the millions of people who could no longer afford insurance would again start flooding ER's around the country to get health care like before the ACA and in many cases it will be advanced diseases or conditions that could have been much more easily and much cheaply taken care of with a doctor's visit. Over all healthcare costs to the hospitals and taxpayers will skyrocket again. Penny wise, pound foolish.

Single payer takes care of the whole problem.

I have to somewhat agree with Hal.  Unless the cost of healthcare can be contained, slowed or reduced, nothing else matters.

Feel free to list all the programs the government has been able to contain, slow or reduce the cost.  I really want to know.  I'm not kidding.  I know there are some.

I remember when I use to write group health insurance before the government became so involved in it.  Premiums for the worse coverage we have today are 5 times as much as they were then.  Unfortunately, anytime you start giving people stuff for free you notice the number of people who want to take advantage of it increases, no matter what you're giving them.

We've been teaching people how to become more dependent instead of teaching people how to become more self reliant.  We've been teaching people to become more dependent by rewarding them for staying dependent.  We've changed our attitude from high expectation of our citizens to no expectations from our citizens.  It's somewhat racist as the common practice is to call people who think they are superior to others by not demanding people get off their ass and put forth the effort to make their lives better.

One of the best things we could do is get the citizens in shape for a change.  Look around you or at yourself.  Americans have to be the fattest people on earth and way too many are in absolute terrible shape because they aren't motivated in the least to get in better shape, there's always a doctor who will prescribe a pill for this and a pill for that.  And if those pills affect you in some detrimental way, there's a pill to contradict the bad effects, so take another pill.

Do they still have recess in schools these days?  Honestly I don't know.  Do they?  When I was growing up and I'm sure the same with most of you we were either doing some kind of physical work or playing.  It doesn't seem to be the same these days.  Everyone I see has their nose stuck in a mobile phone, sitting around doing not much of anything.  Hell, half the parents I know cut their own grass after working all week while the teenager plays on the computer. 

We've spoiled our children and we've spoiled ourselves.  We think we deserve healthcare, no matter how many beers we drank last night or how many joints or cigarettes we smoked.  We don't want to take any responsibility for our own health problems, which we are mostly responsible for in the first place.   Then we want the guy who has been working his tail off to pay his part and our part as well of the premiums to cover him and us and curse him if he objects.

Then we want to put the government in charge of it as if that is going to fix the problem.

My philosophy is and has always been:

I believe we should help those who are unable to help themselves and I believe we should help those who can help themselves do it.

Some premiums for Ky. health exchange to skyrocket in 2017

FRANKFORT, Ky. (WKYT) - Kentuckians who rely on the state's health exchange for insurance should brace themselves for premiums that could skyrocket as much as 47 percent in 2017.

The Kentucky Department of Insurance approved the increases requested by insurance companies selling individual and small group health benefit plans in Kentucky.

While Golden Rule Insurance Company wanted a 65.11 percent increase in its rates, it was only granted one for 47.18 percent. The next highest approved increases were 31 percent for Humana Health Plan individual customers; 29.3 percent for CareSource Kentucky's individual customers; and 27.9 percent for Baptist Health Plan's individual customers; and

"The Department of Insurance carefully reviewed each request to ensure its compliance with Kentucky law, pushed back where possible and sought to ensure each request was properly
supported," said H. Brian Maynard, commissioner of the Department of Insurance.

The department blames the increases on "national trends, market forces, an aging population and the general instability injected in the state health insurance market by Obamacare, insurance companies had requested rate increases."

Maynard says Kentuckians in particular have felt the damaging effects of Obamacare since the failure of the Kentucky Health Cooperative which required the remaining insurers to absorb
the more than 50,000 former Co-op customers. Many of those customers were high risk customers which are driving up costs for others, according to the department.

Commissioner Maynard recommends "during this year's open enrollment period, Kentuckians should consult their health insurance policies to determine how the 2017 rates will affect their premiums and shop around to compare those premiums with other available policies."

In general, insurers' individual premiums will depend on unique factors that include a consumer's age, whether the consumer smokes and where the consumer lives.

~Link~

I don't live in Kentucky. And neither do the vast majority of citizens. Provide information of how it's hurting most people in America as opposed to have more the 24 million losing their health insurance please.

Health insurance premiums on the Affordable Care Act’s marketplaces (also called exchanges) are expected to increase faster in 2017 than in previous years due to a combination of factors, including substantial losses experienced by many insurers in this market and the phasing out of the ACA’s reinsurance program. We analyzed 2017 premiums and insurer participation made available through Healthcare.gov on October 24, 2017, as well as data collected from states that run their own exchange websites.

kff

8 States Where Obamacare Rates Are Rising by at Least 30%

The Affordable Care Act is getting a lot less affordable for many Americans. The landmark law, better known as Obamacare , has meant that 20 million previously uninsured people now have health coverage. Many of them have purchased insurance through state or federally run marketplaces. But insurance companies have been abandoning these marketplaces left and right because they say it's difficult to turn a profit, and the insurers that remain are asking for steep price increases all over the country.

time

Obamacare deductibles are on the rise for 2017, along with monthly premiums

Those cheap Obamacare plans are getting even more expensive.

Deductibles for individuals enrolled in the lowest-priced Obamacare health plans will average more than $6,000 in 2017, the first time that threshold has been cracked in the three years that Affordable Care Act marketplaces have been in business, a new analysis finds.

Families enrolled in bronze plans will have average deductibles of $12,393, according to the study by the consumer insurance comparison site HealthPocket

cnbc

That should get you started.  Here's a little more information to slap some reality into the mix.

Obamacare’s 13th Co-Op Is Closing. Why More Could Follow.

Obamacare’s 13th co-op announced it’s closing ahead of the 2017 open enrollment period, and more of the nonprofit insurers could follow suit in the coming months.

Ohio’s InHealth Mutual announced late last week it would be closing its doors after the state’s Department of Insurance requested to liquidate the insurer.

As insurers prepare to submit proposed rate changes to the government ahead of the next open enrollment period, it’s likely Ohio’s co-op won’t be the last to close its doors.

Obamacare's Co-Op Disaster: Only 7 Remain

July has been rough for Obamacare's non-profit co-op health plans. Four closed after running out of money -- three in just one week . Just seven of the original 23 co-ops are still standing. Those seven all lost money last year -- and may yet go out of business before the calendar turns to 2017 .

All that failure has been pricey. Taxpayers are out $1.7 billion in federal loans that these co-ops will never pay back.

The co-ops stand out as perfect examples of how Obamacare's idea of government-managed "competition" is doomed to fail.

forbes

Aetna to pull out of most Obamacare exchanges

In the latest blow to Obamacare, Aetna is vastly reducing its presence on the individual exchanges in 2017.

The insurer will stop offering policies on the exchanges in 11 of the 15 states where it currently operates, according to a press release it issued Monday evening. Aetna ( AET ) will only sell Obamacare products in Delaware, Iowa, Nebraska and Virginia.

Aetna said earlier this month that it was halting its exchange expansion plans for 2017 and reviewing its participation in President Obama's signature health reform program. The company noted Monday that it has lost $430 million in its individual policies unit since the exchanges opened in January 2014.

money.cnn

Not everyone lives in sunny California.  Kind of reminds me of that Popular Vote.  Not everyone lives in sunny California.

We're worried about the 24 million when there are many more than that who are fixing to lose their insurance with Obamacare the way it is headed.  Maybe we should start thinking how we can cut our losses instead of trying to save a sinking ship.

I do live in KY, which adopted the full plan.  LOTS of people have health insurance for the first time in their lives.  Truly, I've heard very little griping about the rising costs of premiums, other than the usual gripes.  Obamacare has worked here, and no one I know is for this new republican health care plan.

We are a poor state, with most of our population living in rural counties.  Just wait until the Appalachian Development Program shuts down.  It helps a LOT of people and does a LOT of good...  

As Rep. Massie said, HELL NO. 

Sixpick ,

Obamacare has not stopped cost rises. It has slowed them:

For most people, health is one of the most precious things there is (along with family, ...). We will do anything to avoid the catastrophe that is serious illness.

 Then there are other realities:
   - American healthcare decisions are confided to for-profit organizations, not to doctors or patients.
   - There is no penalty for healthcare organisms that gouge their client-patients.

It seems to me that rising costs are inevitable. If there were no government involvement (as before Obamacare), the for-profit healthcare organizations would have no restraint at all.

30% is much lower then they were rising then before Obamacar. Also the 30% rise in insurance doesn't even begin to address the 100's of percent rise in trips to the hospital's ERs each that could have been much more come economically taken care of with an earlier doctor's office visit. Obamacare spoiled us because we forgot all of the diseases that showed up at ER for medical care that were far advanced and which were paid for by taxpayers, that could have been diagnosed and treated by a much, much lower cost in a doctor's office. However since people could not go to a doctor's office let medical conditions get worse until they had no choice but to turn to an ER for help and the ER, under US law, had to treat them. This led to huge costs on private hospitals and even crippling cost to public run hospitals.

Has everyone forgotten that before Obamacare there nightly news in their area was filled with one hospital closure after another? Insurance guaranteed under Obamacare stopped those hospitals from closing which not only meant more people were serviced at a lower cost in doctor's offices, but that more people were employed at hospital specially in the rural areas. And now these maniacs want to stop it?

Now you that you'd destroy it just because you don't like the name that you gave to it. How ignorant to you have to be to want to stop a program that is working overall, instead of just fixing some of it's faults? I'll tell you how ignorant. You have to be so ignorant and so stupid and so touchy that you belong to a political party that named the ACA Obamacare in the first place so that the very name the YOU gave it terrifies you from helping to fix what is basically a great program that just needs some tweaks. Instead you have to get you ass up on some high ideological horse where you are willing to throw of millions of people off from healthcare and fuck the whole system up, just because you promised some voters (who BTW don't want you to do it any longer) that you would. That make's you some kind of special stupid.

We have the making of a good healthcare system that is chugging along and just needs a little help. But because you assholes decided to name it Obamacare you have decided that it is radioactive and won't help fix it and instead want to destroy it for something that will fuck a whole lot of people out of any healthcare in favor of giving a huge tax cut for the already rich.

God-damn you are ignorant fucking idiots! Why not grow up and do what it right for your country for once instead of what the GOP says is right for it? Why not put your country before your party for once? You now I'll bet that if you do you'll feel a whole lot better.

Hey! I have an idea! Fix the problems with it and call or Ryancare! Or Republicare! Or of you really want to make Trump happy call it Putincare!

It seems that the republicans inability to put together a health care plan that they have 6 years to do has affected the way hospitals can plan and are putting on hold facilities that would be of benefit to lower income people/families.

Obamacare's uncertain future has hospitals on hold

Uncertainty surrounding the Republican plan to replace Obamacare is forcing some U.S. hospitals to delay expansion plans, cut costs or take on added risk to borrow money for capital investment projects, dealing an economic blow to these facilities and the towns they call home.

Hospitals typically lay out multiyear operating plans that prioritize investments, such as new clinics, medical wings, technology or other projects that help draw in more patients and increase revenue. In addition to enhancing patient care, these projects are vital to the local economy as a generator of jobs ranging from construction and maintenance to restaurants and transportation.

Denver Health Medical Center, for example, opened a new $26.9 million clinic in the city’s southwest in 2016 to provide care to an area lacking in health services and saw more patients within six months than it had expected over two years. The health system planned to build or remodel five more facilities based on the new clinic’s success.

http://cbsnews3.cbsistatic.com/hub/i/r/2017/03/23/4ec8986d-c95f-4300-8c15-e41908e02d71/thumbnail/760x480/e0c7013b97d41d8d7f2fc72bc7df2e95/0322-rnb-eqv-049506-1275660-640x360.jpg 2x" alt="Republicans scramble for votes on health care bill " height="240" data-srcset="http://cbsnews1.cbsistatic.com/hub/i/r/2017/03/23/4ec8986d-c95f-4300-8c15-e41908e02d71/thumbnail/380x240/2cdaf615373c3ac121744a22fbc93490/0322-rnb-eqv-049506-1275660-640x360.jpg 1x, cbsnews3.cbsistatic 2x">

Play Video

CBSN

Republicans scramble for votes on health care bill

Freedom Caucus Chair Rep. Mark Meadows (R-NC) said Wednesday night he's "optimistic" about finding common ground with the Republican leadership a...

But since November’s election, when Republicans swept the White House and Congress, Denver Health has deferred $73.7 million worth of construction projects that had been planned to serve more low-income residents, many of whom were newly insured under Obamacare.

“We want to know what will happen with the Medicaid expansion population, and what will be the timeline for that,” said Peg Burnette, Denver Health’s chief financial officer. “Due to the uncertainty, we’re not going to issue new debt. We have no plans for that in the near future.”

Denver Health is not alone. Across the country, hospitals are shifting to a more conservative stance as they await sweeping changes to the nation’s health care law that for the first time in U.S. history would reverse a government health care entitlement program. The Affordable Care Act, commonly known as Obamacare, provided coverage to 20 million Americans and brought higher revenues to many hospitals.

The law’s likely overhaul puts many hospitals in a uniquely daunting position of being unable to predict how many of their patients will be insured and what type of coverage they’ll have in the future. As a result, many are more wary than in years past to invest in expensive capital projects, issue debt or expand into new regions, said health care experts and hospital executives.

This is playing out in Arizona, where Kingman Regional Medical Center is taking cost-cutting measures by renegotiating medical supply and service contracts. The University of Alabama at Birmingham Health System, which includes six hospitals, is largely holding off hiring nonclinical staff, a trend also evident in national data.

http://cbsnews2.cbsistatic.com/hub/i/r/2017/03/21/fd2caab4-7f0a-4095-b0e1-fd1c46000247/thumbnail/760x480/78de2fdf6e3f61b596c55387868b6d43/eve-lapook-0321-1274630-640x360.jpg 2x" alt="GOP health plan prompts concern at community health centers " height="240" data-srcset="http://cbsnews1.cbsistatic.com/hub/i/r/2017/03/21/fd2caab4-7f0a-4095-b0e1-fd1c46000247/thumbnail/380x240/bca782d9fe554287598fc8d1b55109b4/eve-lapook-0321-1274630-640x360.jpg 1x, cbsnews2.cbsistatic 2x">

Play Video

CBS Evening News

GOP health plan prompts concern at community health centers

More than 24 million people received health care from community health centers in 2015. Now that changes to Obamacare are under consideration, do...

Across the industry, hospital jobs so far in 2017 grew by 8,775 monthly on average, compared to 11,413 jobs for the same period last year, Bureau of Labor Statistics data shows.

The Republican-proposed bill, set to come before the U.S. House of Representatives on Thursday for a vote, would unwind the Medicaid expansion, cap federal payments to states and replace Obamacare’s income-based tax credits with flat age-based credits. The bill would still need approval in the Senate if it clears the House this week.

When asked about the early signs of hospitals putting spending on hold, a White House spokesperson expressed confidence that “the disastrous Obamacare law will be replaced with the American Health Care Act -- the vehicle which will reform our broken health care system.”

The nonpartisan Congressional Budget Office estimates the new proposal would cause 14 million people to lose health insurance next year and 24 million by 2026. The bill has divided House and Senate Republicans and sparked fierce criticism from Democrats and leading medical and hospital groups, including the American Medical Association and American Hospital Association.

“It’s very challenging to plan for your future in an environment like this,” said Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, a group that represents safety-net hospitals nationally.

Not all hospitals are on hold. Some health care groups in areas with growing populations, such as Atlanta and Houston, are pushing ahead with capital expansion projects. Others, such as Maryland’s Prince George’s County, are still planning to move forward with construction plans, thanks in part to a partnership with the University of Maryland Medical System.

With the new medical center, Prince George’s County hopes to end its long-time reliance on $30 million annually from public subsidies to help cover operations. But that goal assumed Obamacare would remain intact, said Thomas Himler, Prince George’s deputy chief administrative officer.

“It could be that three years out we are no longer making money, we are losing money,” said Himler.

The uncertainty has seeped into the municipal bond market, where nonprofit hospitals access capital. The sector sold 36 percent less debt for new projects so far in 2017, compared to the same period last year, while the rest of the municipal market increased the amount of new money issued by 23 percent, Thomson Reuters data shows. While municipal analysts say it’s too early to draw conclusions, the uncertainty surrounding Obamacare is a likely cause for the decline.

“There’s a wait-and-see feeling,” said Kevin Holloran, a senior director at S&P Global Ratings. “Hospitals are saying, we’ll revisit this in six months or more.”

In other words republicans put up or shut up.

 

Don't seem to get it.  It's a waste of time trying to argue about how much it has come down or anything else.

The fact is I'm telling you a train is coming and you better get off the tracks and you're telling me there hasn't been a train by here in years.

Sixpick , 

The fact is I'm telling you a train is coming...

France was one of the last European countries to have universal health care. The system was created over sixty years ago under that notorious leftist, Charles de Gaulle...  

(The German safety net goes back to the 1880s, and the other notorious leftist, Otto von Bismarck.        )

I have contributed to, and been covered by French healthcare for forty years. It is not perfect, but...  French people do not live in fear of a medical crisis . French people live  a couple  years  longer than Americans, and they pay about half of what Americans pay for healthcare (both individually and as a percentage of GDP).

Clearly, America does not manage its healthcare as well as France, but...

I  refuse  to believe that America  cannot  do as well as France .

In short …

Another lie on offer from the GOP: that Obamacare is driving up health costs.

The fact is, Obamacare isn’t doing that. 

Insurance companies  are, by charging more money each year, just like they always have. And statistics show that states that refuse to run their own exchanges have seen the  biggest premium hikes.

The incessant Republican lies about Obamacare, and, the ignorance of those who don't realize that repealing Obamacare means the loss of THEIR COVERAGE … together have enabled insurers to do what they always do because THEY ARE NOT SUBJECT TO ANTI-TRUST LAWS … namely, raise rates …

… AND CONVINCE THE ZEAL-WITHOUT-KNOWLEDGE, LOW INFORMATION VOTERS THAT IT'S THE FAULT OF OBAMACARE!

Wake up folks … the ones who tell you "you're being had," are the ones having you!