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Tags Affordable Care Act , AHCA , donald trump , health care issues , health insurance issues , obamacare , Trumpcare

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Old 25th February 2017, 04:15 PM   #561
Stacko
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Holy ****! Leaked report suggests millions could lose coverage under GOP health proposal.

Quote:
The report estimates what would happen in a hypothetical state with 300,000 people in the individual market that has also expanded Medicaid. In the individual market, enrollment would fall 30 percent and 90,000 people would become uninsured.

An additional 115,000 people in that hypothetical state may also lose coverage because they are enrolled in Medicaid and cannot find an affordable private plan.

The report estimates that coverage declines would be even higher in states that did not expand Medicaid — largely those run by Republican governors. There, the report presents an example of a state with 235,000 in the individual market. It estimates that coverage would decline by 120,000 people, about 50 percent.


Gotta get those tax cuts for the rich.
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Old 26th February 2017, 11:46 AM   #562
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Originally Posted by Dr. Keith View Post
Here we ask our insurance company if it is covered. They either allow or deny the procedure with almost no insight into why. Most normal stuff is covered most of the time. If it is denied the patient can appeal the decision within the insurance company if the doctor is willing to go to bat for them and say it is necessary. If it is still denied I would assume you go to arbitration. I don't think these cases often make it into court because the insurance companies don't want them to.

Interestingly, some doctors make the case that a high percentage of medical procedures don't really help the patient and may well cause harm, even death:
http://www.theatlantic.com/please-su...517368%2F#seen
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Old 26th February 2017, 03:27 PM   #563
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Originally Posted by Bob001 View Post
Interestingly, some doctors make the case that a high percentage of medical procedures don't really help the patient and may well cause harm, even death:
http://www.theatlantic.com/please-su...517368%2F#seen
From that Atlantic article, one of the most pertinent quotes:
Quote:
They would never know they had a tear if not for medical imaging, but once they have the imaging, they may well end up having surgery that doesn’t work for a problem they don’t have.
Patients who had sham surgery and physical therapy did just as well as patients who only had physical therapy.

The imaging is an issue, I just went through this with my 92-year-old mom who was on the bubble for needing a stint (straw-like devices that prop open arteries). I authorized it and made sure the hospital had her living will on file. It might have done her no good.

There is one stint she got that seemed very effective and that was to a renal artery. It dramatically reduced her blood pressure. But per the article, that didn't necessarily make her healthier. Bodies are complicated organic systems. Blood vessels aren't faucets. Bones aren't just scaffolding. Things that seem to make intuitive sense don't necessarily improve health.
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Old 26th February 2017, 04:12 PM   #564
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Originally Posted by Bob001 View Post
Interestingly, some doctors make the case that a high percentage of medical procedures don't really help the patient and may well cause harm, even death:
http://www.theatlantic.com/please-su...517368%2F#seen
That article was incredibly disturbing. My guy at the mall with some YouTube and Wikipedia training scenario is starting to look more reasonable.
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Old 26th February 2017, 09:09 PM   #565
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Originally Posted by Civet View Post
That article was incredibly disturbing. My guy at the mall with some YouTube and Wikipedia training scenario is starting to look more reasonable.
Chances are your guy at the mall wouldn't attempt heart surgery, and you'd likely be better off for it.
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Old 26th February 2017, 11:20 PM   #566
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Oops, I meant stent, not stint.
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Old 26th February 2017, 11:45 PM   #567
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Originally Posted by plague311 View Post
My son needs a root canal and the dentist wants $1300 up front. In America that isn't "health care", yet it directly effects his health.
I'm in Canada 🇨🇦 ... poster boy of free Health Care ... I was eating hard candy from my kids Halloween treats on All Hallows' Eve' .. cracked an old repaired molar (about one fourth of the tooth on the distal side is missing, second tooth from the back, on my left side)

It's almost March and it's not fixed yet ... have to save up cash as dental work is not covered here for working families (have to be on welfare for free dental care)

I also pay for all my prescription drugs, three different concoctions to keep my blood pressure out of the stratosphere, that's also not covered here, unless you're old or on welfare.
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Old 26th February 2017, 11:47 PM   #568
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Originally Posted by jaydeehess View Post
ahhh, there's the rub. In the Canadian province of Ontario dental procedures are also not covered, UNLESS, there is a danger to life involved. Not sure if root canal qualifies.
The only option covers for dental is pulling teeth out
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Old 27th February 2017, 04:53 PM   #569
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The Obamacare repeal is dying a slow, conservative death.

Quote:
Two prominent House conservatives said Monday that they would vote against a draft of the Republican Obamacare repeal bill that was leaked last week, presenting a serious roadblock to the GOP's increasingly complicated efforts to dismantle the Affordable Care Act.

Republican Rep. Mark Meadows, the chairman of the conservative House Freedom Caucus, told CNN on Monday that he cannot support a draft of the GOP Obamacare repeal bill unless substantial changes are made.
Hours later, Rep. Mark Walker, the chairman of the Republican Study Committee, announced that he, too, could not support the leaked version of the legislation.

The comments come as top House Republicans are preparing to unveil legislation to repeal major portions of Obamacare and are struggling to bridge deep divisions within their own conference.
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Old 27th February 2017, 09:20 PM   #570
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Trump just realized that the health care issue is complex.....projects that "no one knew."
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Old 28th February 2017, 01:42 AM   #571
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Originally Posted by Stacko View Post
But please note that their objections aren't that millions of Americans in the direst need will lose their health insurance but rather that the provisions are far too generous:

Quote:
Meadows told CNN that what is unacceptable to him are the refundable tax credits included in the draft of the bill. Those tax credits, the North Carolina congressman said, are nothing short of an "entitlement program."
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Old 28th February 2017, 02:28 AM   #572
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Originally Posted by The Don View Post
But please note that their objections aren't that millions of Americans in the direst need will lose their health insurance but rather that the provisions are far too generous:
Tax cuts are for the rich, what's the point of giving the less well off say 10 bucks a week? That won't even buy a well done steak!
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Old 28th February 2017, 03:10 AM   #573
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Originally Posted by Darat View Post
Tax cuts are for the rich, what's the point of giving the less well off say 10 bucks a week? That won't even buy a well done steak!
'Less well off "people should not eat steak ... it's too expensive for their "income'
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Old 28th February 2017, 04:31 AM   #574
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Originally Posted by Dr. Keith View Post
My impression of UHC countries is that they evaluate a treatment and when and how it should be administered. Then that evaluation applies to everyone equally. So, if the patient falls into these guidelines then it is determined that treatment X would be an effective treatment, but if patient does not fall within the guidelines then treatment X would not be considered effective.

I could be completely wrong, since I'm not in any way associated with medicine or medical policy.
But that doesn't fit her narrative so she is ignoring what life time maximums really mean by changing it to a cost benefit analysis of a particular treatment.
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Old 28th February 2017, 04:33 AM   #575
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Originally Posted by Emily's Cat View Post
I don't understand your post. The snippet of discussion here was specifically about lifetime maximums.
No you moved the goalpost from life time maximums to specific cost benefit analysis of one condition. You totally ignored past expenditures(ie the things that would add up to a lifetime maximum) in your discussion of if a treatment would be administered to save a life or not.
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Old 28th February 2017, 04:37 AM   #576
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Originally Posted by Dr. Keith View Post
Not that I want to see our friend EC out on the street, but the fact that we have this massive health insurance industry in the US that eclipses similar industries in other western nations is our biggest problem. People don't need health insurance, they need health care.

Obamacare's bigger fault was in not offering a medicare for all option alongside the insurance options. We need to take out the middle man.
It is too big to fix. Think of all the people who would be put out of work. We need to view it as the massive jobs program that it really is. Tons of white collar make work jobs.
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Old 28th February 2017, 04:42 AM   #577
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Originally Posted by Darat View Post
Tax cuts are for the rich, what's the point of giving the less well off say 10 bucks a week? That won't even buy a well done steak!
At least they have ketchup to make it almost as if they are eating a dry aged well done steak.
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Old 28th February 2017, 10:04 AM   #578
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Originally Posted by thaiboxerken View Post
Trump just realized that the health care issue is complex.....projects that "no one knew."
Nope, nobody knows that!
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Old 28th February 2017, 10:07 AM   #579
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Originally Posted by Emily's Cat View Post
Nope, nobody knows that!
There is really no way they could know.

He really had to dig into it to find out. Glad he didn't do that before the election, he may have had to employ a more nuanced take on the situation than "Repeal Obamacare!" and "Lock her up!"
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Old 28th February 2017, 10:17 AM   #580
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Originally Posted by Dr. Keith View Post
There is really no way they could know.

He really had to dig into it to find out. Glad he didn't do that before the election, he may have had to employ a more nuanced take on the situation than "Repeal Obamacare!" and "Lock her up!"
How could he know that Obama made ACA an extra complicated disaster, leaving him a total super mess. Obama is after him. Best to lock him up too.
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Old 28th February 2017, 10:24 AM   #581
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Originally Posted by carlosy View Post
How could he know that Obama made ACA an extra complicated disaster, leaving him a total super mess. Obama is after him. Best to lock him up too.
True Obama is the organizing and funding of all the actors pretending to protest against him.
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Old 28th February 2017, 11:00 AM   #582
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Originally Posted by carlosy View Post
How could he know that Obama made ACA an extra complicated disaster, leaving him a total super mess. Obama is after him. Best to lock him up too.
TBF, ACA is complicated, but the underlying health insurance market isn't really much less complicated. Health insurance in the US, irrespective of the payment mechanisms involved, is a very complicated thing. Some might call it a ***********. Some might use a slightly more blue term than that polite spoonerism.
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Old 28th February 2017, 11:30 AM   #583
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Originally Posted by Emily's Cat View Post
TBF, ACA is complicated, but the underlying health insurance market isn't really much less complicated. Health insurance in the US, irrespective of the payment mechanisms involved, is a very complicated thing. Some might call it a ***********. Some might use a slightly more blue term than that polite spoonerism.
I can imagine that.

Out of curiousity, is it really that complicated and hard to revise the US health system (technically) or is it more like everyone knows how to do it, but nobody has the guts, because it would "hurt" some well organized lobby groups?
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Old 28th February 2017, 11:33 AM   #584
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Originally Posted by carlosy View Post
I can imagine that.

Out of curiousity, is it really that complicated and hard to revise the US health system (technically) or is it more like everyone knows how to do it, but nobody has the guts, because it would "hurt" some well organized lobby groups?

There are an awful lot of administrators who'd be out of a job.

As Emily's Cat is so keen to point out, a major part of the problem is that doctors in the USA earn much, much more than they do elsewhere. Fixing the problem properly, to bring costs in line with the rest of the world, would involve a large cut to doctor's salaries.

You'd need to get by the AMA which, at the behest of it's members, heavily restricts the number of doctors graduating each year. A bit like De Beers and diamonds.
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Old 28th February 2017, 12:11 PM   #585
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Originally Posted by carlosy View Post
I can imagine that.

Out of curiousity, is it really that complicated and hard to revise the US health system (technically) or is it more like everyone knows how to do it, but nobody has the guts, because it would "hurt" some well organized lobby groups?
No, nobody really "knows how to do it." There are numerous entities that have legitimate but conflicting interests. If you look at universal coverage systems around the world, there is no one model. Some use a national health system like the UK, where most providers work for the government. Many, like Germany and Japan, use private insurers that are closely regulated, like public utilities. The approach that would probably get the most support would be something like Medicare-for-All, supported by an increase in payroll taxes. But insurance company and hospital company executives wouldn't be able to collect multi-million dollar bonuses.
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Old 28th February 2017, 12:13 PM   #586
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Originally Posted by 3point14 View Post
....
You'd need to get by the AMA which, at the behest of it's members, heavily restricts the number of doctors graduating each year. A bit like De Beers and diamonds.
Doctors aren't the problem. The problem is how they are paid -- and what they have to do to get paid. Quite a number of doctors join HMOs for salaries, regular hours and a reduction in administrative paperwork.
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Old 28th February 2017, 12:55 PM   #587
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There is no single issue that if fixed would solve our high healthcare costs and poor access. I work in supply chain for a large healthcare org and there are problems that contribute to high costs there as well
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Old 28th February 2017, 01:09 PM   #588
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Originally Posted by carlosy View Post
I can imagine that.

Out of curiousity, is it really that complicated and hard to revise the US health system (technically) or is it more like everyone knows how to do it, but nobody has the guts, because it would "hurt" some well organized lobby groups?
It actually is that complicated That doesn't mean that there aren't some very motivated lobbyists involved as well.

One of the major complications that often gets overlooked is how closely interconnected many elements of the health industry are. In other developed countries, political leaders looked around relatively early on in the process and said "Hmm, this health care thing seems like it could get messy. Let's avoid that and go ahead and centralize it now before it gets too big". The US didn't. There's a ton of history that can go into that, including the fact that health insurance had it's beginnings in the US. It started as ancillary products sold in the workplace alongside life insurance: critical illness benefits, AD&D, disability insurance, etc. In its infancy, health insurance was simply another tool for financial protection.

Somewhere in the 30s, however, things changed. History isn't my strong suit, so dates aren't going to be part of this discussion . At some point, there was a wage freeze - employers weren't allowed to pay higher wages. Don't ask me why, had something to do with the great depression and/or WW2. Anyway... employers still had a need to compete with each other for labor, so they began adding non-wage compensation to the package: group life insurance for example. This was the first time that something resembling modern health insurance showed up. Much of that went hand-in-hand with the beginning of the blue cross association. BCA went out and contracted with hospitals so that they could offer better packaged rates to those employers. It was all downhill from there.

Once that initial foot was in the door with employer-sponsored health insurance, we saw the expansion of those contracted hospitals to include physician services, then prescription drugs, screenings, routine care, and preventive. Hospitals started contracting with medical suppliers, technical services, etc. Physicians started banding together to increase their negotiation power. Insurance companies relied on independent insurance agents for distribution. The states started taxing premiums. Insurers began acting as a conduit for access to medical services instead of just financial protection.

We're at a point where a fundamental restructuring of the industry affects the livelihood of hundreds of thousands of people. Who pays the bill isn't even the largest of the problems in the US health care industry.

Other countries didn't go down that same path - they didn't have the same hand-in-hand growth that the US did. They employed their power to learn vicariously, and sidestepped a lot of the potholes we've got. They never developed a health insurance broker industry, because they really never had a mature private health insurance marketplace. They never developed 3rd party pharmacy benefit intermediaries, because the never had a mature health insurance industry that needed to contract directly with pharmaceuticals to provide access to drugs. They never ended up in the gordian knot of provider costs that we're facing, because they never really had to deal with provider contracting in the same way the US does.

So yeah, it actually is more complex.
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Old 28th February 2017, 01:30 PM   #589
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Originally Posted by carlosy View Post
I can imagine that.

Out of curiousity, is it really that complicated and hard to revise the US health system (technically) or is it more like everyone knows how to do it, but nobody has the guts, because it would "hurt" some well organized lobby groups?
I've had a bit of experience interacting with lobbyists and I've noted that they are incredibly good at making the group they represent seem like a vitally important part of any relevant process whose interests must be respected lest catastrophe result. They tend to be particularly effective when dealing with people less informed about the field (which, of course, includes many politicians).
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Old 28th February 2017, 01:31 PM   #590
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Originally Posted by Emily's Cat View Post
-----
Somewhere in the 30s, however, things changed. History isn't my strong suit, so dates aren't going to be part of this discussion . At some point, there was a wage freeze - employers weren't allowed to pay higher wages. Don't ask me why, had something to do with the great depression and/or WW2.
......
I just note that wage and price controls were imposed during World War II, to prevent -- or at least discourage -- war profiteering and market distortions that would cause shortages of basic goods.
http://www.u-s-history.com/pages/h1689.html
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Old 28th February 2017, 01:44 PM   #591
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What is the big deal with repealing the ACA, they had the plan worked out last year only to have the president veto it, just push that through again. Simple people really how hard is that?
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Old 28th February 2017, 01:49 PM   #592
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Originally Posted by ponderingturtle View Post
What is the big deal with repealing the ACA, they had the plan worked out last year only to have the president veto it, just push that through again. Simple people really how hard is that?
Because the ACA has many parts. Simply repealing it would mean returning to the pre-2010 landscape: Pre-existing conditions would keep people from buying insurance at any price, people could have their insurance canceled on pretexts if they started racking up big bills, adult children couldn't remain on their parents' insurance, small employers wouldn't have to offer insurance, money for Medicaid would be cut, etc., etc., etc. It turns out that many people actually like -- and benefit from -- the ACA; they just hate that nasty old "Obamacare."

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Old 28th February 2017, 01:53 PM   #593
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Originally Posted by Bob001 View Post
Because the ACA has many parts. Simply repealing it would mean returning to the pre-2010 landscape: Pre-existing conditions would keep people from buying insurance at any price, people could have their insurance canceled on pretexts if they started racking up big bills, adult children couldn't remain on their parents' insurance, small employers wouldn't have to offer insurance, money for Medicaid would be cut, etc., etc., etc. It turns out that many people actually like -- and benefit from -- the ACA; they just hate that nasty old "Obamacare."
It is almost as if they never intended any of their votes to pass so they didn't need to have then written in a form they cared about. But they would never do a pointless grandstanding gesture like that.

Hmm imagine how much they would have panicked if Obama had signed it instead of Vetoed it...
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Old 28th February 2017, 05:12 PM   #594
Blue Mountain
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Originally Posted by Bob001 View Post
No, nobody really "knows how to do it." There are numerous entities that have legitimate but conflicting interests. If you look at universal coverage systems around the world, there is no one model. Some use a national health system like the UK, where most providers work for the government. Many, like Germany and Japan, use private insurers that are closely regulated, like public utilities. The approach that would probably get the most support would be something like Medicare-for-All, supported by an increase in payroll taxes. But insurance company and hospital company executives wouldn't be able to collect multi-million dollar bonuses.
This. There are counties that use private insurance and manage to provide coverage for all. So why can't the USA do it?
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Old 28th February 2017, 08:31 PM   #595
thaiboxerken
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Originally Posted by Blue Mountain View Post
This. There are counties that use private insurance and manage to provide coverage for all. So why can't the USA do it?
Republicans, that's why.
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1. He'd never do that. 2. Okay but he's not currently doing it. 3. Okay but he's not currently technically doing it. 4. Okay but everyone does it. 5. He's doing it, we can't stop him, no point in complaining about it. 6. We all knew he was going to do it which... makes it okay somehow. 7. It's perfectly fine that's he's doing it.
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Old 1st March 2017, 06:31 AM   #596
Bob001
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Originally Posted by ponderingturtle View Post
It is almost as if they never intended any of their votes to pass so they didn't need to have then written in a form they cared about. But they would never do a pointless grandstanding gesture like that.

Hmm imagine how much they would have panicked if Obama had signed it instead of Vetoed it...
It's an interesting thought exercise. Obama could have said "I have decided to comply with the will of the people, as expressed by the legislators they have elected. Of course, if this isn't really what the people want, they could send somebody else to Congress...."
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Old 1st March 2017, 03:29 PM   #597
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The latest draft of the Obamacare repeal is available. To Republican legislators only. It's literally being kept in a basement where people have to go to read it. All that's missing is the sign saying "Beware of the Leopard".

Quote:
House Republicans on Thursday plan to release details of a measure that would repeal Obamacare and replace parts of it, a key lawmaker said.

Rep. Chris Collins, a member of the Republican leadership team who sits on the House Energy and Commerce Committee, which authored the legislation, said it would be made available Thursday morning to Republicans in a basement room of an office building that adjoins the Capitol.

“No one is getting a copy,” the New York lawmaker told the Washington Examiner. “We can go and read it.”
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Old 1st March 2017, 03:54 PM   #598
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Republicans are going to silly lengths to avoid meeting with their constituents over their ACA replacement plan. WI Senator Johnson just sent a cease and desist letter to constituents who want a town hall meeting.
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Old 1st March 2017, 09:02 PM   #599
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The Donald will hire a focus group made up exclusively of Vegas magicians, and it will happen.
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Old 1st March 2017, 09:07 PM   #600
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Eliminating all of the overhead and headaches that come with various people (patients, medical office staff, hospital office staff, etc.) dealing with the insurance companies...

Which, in real life, translates to paying a bunch of extra paper-pushers salary + benefits...

Yes, we would definitely save money by cutting out the middleman. And people would be less afraid to access care when they become symptomatic, because they would be less afraid of the resulting bill if we had Medicare For All.
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