Wednesday, July 12, 2017

In the News - Healthcare Reform and Travel Bans

David:
There is a great deal of news in the media recently, and some of it is actually important. One of the things I thought we might analyze is the pros and cons of the current health-insurance-reform bill.  Currently, it is stuck in a quasi-limbo state in the Republican-controlled Senate.

The main two sticking points, as I see it, are how to curb the uncontrolled expansion of Medicaid under Obamacare, and how to restore freedom of choice in the insurance marketplace.

Doug:
It is funny how "freedom of choice" is one of your "two sticking points" on insurance. You are "pro-choice"! Most people would rather have good, low-cost healthcare rather than a choice of terrible, expensive insurance. Why do we even need insurance on healthcare? Everyone needs healthcare. Insurance for something everyone needs is not necessary. It is like having insurance for food. We can save money by bypassing the health insurance middleman. Everyone needs to be educated, so we have public education in this country. Everyone needs healthcare. The Republicans are paving the way for single-payer healthcare. Perhaps they really want single-payer healthcare, but they just don't want to do it themselves.

David:
That just isn't true at all. The vast majority of people don't require any interaction with a physician for most of their lives.

Doug:
Shorter: most people don't need a doctor, until they do. You especially don't need a doctor once you die. If you want to save money, get poor people to die earlier. Say, you don't think...

David:
Ah. So you're against right-to-die laws that allow you to refuse medical interventions. I'm for freedom to make your own health-care choices.

Once you've been born and get immunizations, most will not need anything that the health care industry provides for decades. Most would like to have insurance for emergencies, and they should, and they want to be able to get it cheap. That is the underlying structural deficit of Obamacare: It mandated that all insurance carriers must provide services that the majority of Americans didn't want or need, and that drove premiums through the roof. As an example, if the government mandated that all auto insurance provided for gas, tires, and oil changes, no one would be able to afford car insurance.

Doug:
I don't know about Indiana, but the state government of Pennsylvania does mandate that my tires, headlights, turn signals, engine, and the rest pass inspection. And that costs money. Not a lot, and it goes directly to the doctor, er, I mean, mechanic. And insurance is mandated as well. So to follow your analogy, you are either suggesting that the car inspection services and car insurance agencies should be the same companies, or you are suggesting that health insurance companies also do mandatory checkups. Somehow many people can still afford to drive cars in PA.

David:
You get to choose whether or not to drive. It's a privilege, not a right. If you choose not to drive, you don't have to pay those fees. And the money for the inspections goes to the government. And car insurance is available over the internet, and there are hundreds, if not thousands of auto insurance companies that provide a host of services.

Doug:
Not everyone needs a car. But everyone needs health, until they don't. Healthcare insurance should be regulated at least as well as car insurance:
"Insurance companies are part of a large industry — one of the largest and most profitable in the United States. It’s important for these companies to be tightly regulated."  - autoinsurance.org
Tightly regulated. That is part of what Obamacare did. You couldn't buy an insurance policy that did nothing, even if you wanted to, just like car insurance. And Obamacare was curtailing costs, until the current Republican administration starting whacking on it.

David:
This plethora of options and competition keeps prices lower. Health insurance should follow that model. Many companies, with a menu of services, that you can buy online would create a true marketplace and keep premiums low. If you want to wait until you're older to purchase insurance, you can do so. At least we can agree that most people want good, low-cost insurance.

Education is provided by the states, not the federal government. If you're arguing to return health care back to the states, then I'm all in.

Another important piece of news this week was a unanimous decision by the Supreme Court to allow the majority of President Trump's travel ban to be enacted, rebuking the lower court's decisions to stop it. While you may disagree with the ban itself, this decision certainly reinforces the separation of powers set forth in the US Constitution. Immigration is not within the prerogative of the judicial branch.

Doug:
Whoa there fella! You missed a step. The Supreme Court has not heard the Muslim ban case yet; it merely scheduled for a hearing in October 2017. That will be after the 90-day imposition defined by the executive order itself, so it will be interesting to see if a Supreme Court ruling has any effect. But it would be more interesting to see if they rule on whether a President can enact orders that are illogical even if he has the right under the constitution.

David:
Whoa there yourself. While the SCOTUS has not heard the final case yet, they did, as a mater of fact and law allow the majority of the ban to be enacted. The other thing you apparently fail to realize is that the courts can decide if something is constitutional, but they don't get to decide if a decision is wise or not.

Doug:
Wise? I didn't say wise. I said "logical." Can a President issue an Executive Order about growing flowers in Finland? I guess he can. But is it logical?

David:
Can you imagine if the President nominates a Supreme Court justice, and the Senate confirms that candidate, and then the court rules that the nominee isn't who they would have chosen? Apparently you can, if you believe they'll overrule a constitutional order because they don't like how it plays out, or disagree with the logic behind it. Since this preliminary decision was unanimous, it indicates that they felt the merits of this case give the President a high likelihood of success in October.

Doug:
There was other import news this week. Some state governments shutdown this past week. That had an impact on people's 4th of July travel plans. Here is a beach that closed to the public. Hey! There are some people there:


Can we zoom in? Ah, Republican Governor of New Jersey, Chris Christie:


Three states did not pass budgets: New Jersey, Maine and Illinois. All three have Republican governors.

David:
Right. Three Republican governors all insisted that their legislatures send them budgets that balance and make sense. Governor Christie can't sign a budget bill, because the Democrat-controlled legislature didn't send him a bill to sign.

Doug:
Poor Chris. Let's make Chris Christie the face of Republican party. There was also news on the healthcare front: the Republicans failed to bring their secret health care bill (also know as the Big Tax Cut for the Rich) to a vote. That means more time to examine what effect this will have on the economy and lives.

David:
Which is the original point that I brought up in this blog. Was that picture of Christie sitting on the beach so jarring that your train of thought derailed?

Doug:
Yes, the Republican hypocrisy always derails my train. I didn't understand that when you said "health-insurance-reform" that you were referring to the "Big Tax Cut for the Rich."

David:
While Democrats, and you, portray the bill as a freebie for the rich and a death sentence for everyone else, there are lots of things within the bill that actually do need some discussion.

Doug:
Ya think?!

David:
Sure. There are things that should have been discussed when Democrats originally forced Obamacare through on Christmas Eve, without entertaining any Republican amendments.

Doug:
I think it is certainly true that congress entertained hundreds of amendments. 564 amendments, to be exact. Many of those (hundreds actually) were technical in nature. But many were substantial, like the lack of a single-payer option. But it took time to offer hundreds of amendments, don't you agree? Time that seems to be unavailable with the Republicans in charge.

David:
No Republican amendments saw the light of day. Not very bipartisan. Once the bill gets through reconciliation, then perhaps Democrats will be willing to sit down and make corrections. Right now, they have refused to participate in anything other than some minor tweaks around the edges. You can't paint a Yugo a different color and then call it a Cadillac.

The discussion should happen with the few Democrats who actually are willing to admit Obamacare didn't pan out and is about to collapse, and with the Republicans who will admit that the discussion on healthcare has changed in the past 8 years.

Doug:
Obamacare is not ready to collapse. But if you say it often enough maybe someone will believe you. Obamacare is not ready to collapse.

David:
There are entire states that now have no coverage from the exchanges. That sounds like a collapse.

In my opinion, Republicans should once again pass the repeal bill they passed in 2015, and then sit down at a big table and start over with compromise in mind. There were things in Obamacare that people liked, and there will certainly be things from this new bill that will make things work much better.

Doug:
You are wishfully describing Obamacare in the past tense.

David:
Turning Medicaid into block grants, and allowing the states to manage the system by their own rules will likely lead to more innovation and better coverage for more people at less cost.

Doug:
Obamacare was a compromise. Single-payer is what we should have done to begin with. Why is Obamacare so hard to replace? Because it is fundamentally conservative.

David:
It was a compromise with Democrats who didn't want a single-payor system. There was no input from Republicans, and no compromise with Republicans.

Doug:
Also, Trump couldn't stop himself from tweeting on what's on his mind, including more talk about a woman bleeding:

Why is he talking about Mika's face?

David:
You just can't help talking about his tweets, can you? Neither can the media. Maybe his strategy is working (whatever his strategy regarding the tweeting is...).

Doug:
In the second tweet above, Trump implies that he controls what the National Enquirer prints. Why would he say that? Perhaps blackmail?

David:
I hate to get dragged into another discussion about Trump's crazy tweets, but in this instance, the second tweet was in response to a comment from Joe Scarborough that Trump refused to intervene regarding a National Enquirer story. Unnamed, anonymous sources at the White House claim it was Scarborough, who had been on good terms with Trump previously, requested his friend Jared Kushner ask Trump to call the publisher of The Enquirer to kill an unflattering story about the two Morning Joe hosts and their relationship. I doubt Trump ever even heard anything about any of it. That was months ago. Rather than Trump threatening blackmail, it sounds like Scarborough was pleading for assistance from an old friend.

Doug:
I've said it before, and I'll say it again: this man does not have the temperament to be president. I think these smaller crimes may be his undoing with his base. But that may just be wishful thinking.

David:
Tweeting isn't a crime, big or small. And from what I've seen, the base loves it. You've said a great many things about Trump during the campaign, and since the election, and so have I. And yet there are things still getting done. If you watch the news, however, you'd think that tweets are all the President does all day. Maybe he'll stop tweeting at some point, but I doubt the media would focus on any of the positive news anyway. They'd just start attacking this administration about something else.

Doug:
Это все на этой неделе!

David:
Almost. I still find it to be an example of Democrat and media hysteria that if you talk to someone who is Russian, that conversation is equated to talking to "THE Russians". It's as if every Russian is a representative of Putin himself. I've worked with several physicians who were Russian. Does that mean I've colluded with THE Russians? Okay, now we're done.

Doug:
No, we are not done. Why would you think that, and why would you think you could declare it? It is a ridiculous assertion that the Republicans were just talking to plain old Russians. I have Russian friends. I have professional colleagues who are Russian. I have students that study in Russia. But there is a quite clear difference between such people and Russian Oligarchs and those acting on behalf of Putin. You really want to claim that Natalia Veselnitskaya is just a regular Russian? Chuck Grassley was already investigating her:



Grassley, an Iowa Republican. She shouldn't even be allowed in the country! In any event, I guess we want to find out exactly who she is and what she was selling. We don't want to sweep her under the rug and assume that she is just a regular Russian citizen. Right? We want to know. We want to know if Trump is a puppet.

David:
Your own comment lists her as an undeclared lobbyist. Not exactly the same as a Putin spokesman. Nice try. Now we're done.

Doug:
You sure want this to be done. You are right though: Natalia didn't describe herself as a "Russian Spy." If you read Grassley's request, you'll see that part of this goes back to the Obama Justice office. This is much more interesting if you actually look at the facts.

David:
See you all next week!

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