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Is this the Republican alternative to Obamacare?

REUTERS/Jonathan Ernst
Sens. Tom Coburn, left, and Richard Burr (along with Sen. Orrin Hatch) have introduced a bill they are calling the "Patient CARE Act."

At some point in their efforts to repeal the Affordable Care Act, Republicans started saying that they wanted to not only repeal but also replace the law with something better. But mostly, when asked what the replacement would be, Republicans have offered few specifics and only a few pitifully vague adjectives — “patient-centered,” “less intrusive” and other relatively meaning-free words and phrases.

Perhaps that has changed. Three Republican senators — Tom Coburn of Oklahoma, who is a physician, Orrin Hatch of Utah and Richard Burr of North Carolina — have introduced a bill that would repeal the Obamacare law and replace it with they are calling the “Patient CARE Act.” (CARE is an acronym for “Choice, Affordability, Responsibility and Empowerment.”)

It’s too soon to call it the Republican offer to replace Obamacare, since the party has not embraced it. But I expect it will pick up co-sponsors and it could become the vehicle for Repubs to argue that they do too have a plan. Forbes magazine has called it “the most thoughtful and constructive plan yet developed to repeal and replace Obamacare.” It picks some features of Obamacare, slims down others, and drops quite a few.

I can’t grasp all the moving parts. But here are a few. There is no individual mandate requiring the uninsured to get insured (or pay a fine). There are no “exchanges” to enable individual shoppers for health insurance to compare plans. PCARE would (as Obamacare does) expand the eligibility for Medicaid, but not as much. So some families on the border of poor and working class would be left out. Mandating that kids can stay on their parents’ policies until 26 and a ban on lifetime caps would both stay in the law.

The ban on insurance companies refusing to accept those with pre-existing conditions is mostly gone, although if you already had insurance when you developed such a condition, your insurer couldn’t drop you or raise your premiums. Obamacare offers tax credits to help families afford health insurance. PCARE would too, but would change the income-boundary for who gets the credit (thus fewer families would be eligible for that form of subsidy).

A big and perhaps surprising difference (given the general Republican attitude to tax increases) is that PCARE introduces a large new tax on those who get insurance through their jobs. Under current law, those employees don’t pay any income tax on the money their employers pay to insure them. Under PCARE, employees would pay income taxes on 35 percent of the employers’ contribution. For middle- and especially upper-middle-class families, this would probably be a significant tax hike.

Well, I’d better stop there for now. It’s clear to me that more people would end up without insurance. It is still a big new “intrusion” of government into the workings of the private health-insurance market, but not nearly as big as Obamacare. It seems possible, even likely, that some movement in this direction could have been negotiated in 2009-10 if Republicans had offered to support a compromise law instead of deciding to all vote against the ACA so they could then forevermore denounce the law on the grounds that it received no Republican votes.

There are several summaries with more details. I relied on this one by Ezekial Emanuel from the New York Times op-ed page. Here’s one from the libertarian magazine Reason, written from a viewpoint sympathetic to the Coburn law.

Comments (49)

  1. Submitted by jody rooney on 01/30/2014 - 10:48 am.

    Ban on pre existing conditions mostly gone

    What happens when common disease of the aged get labeled pre existing conditions like Type I diabetes, or breast cancer or testicular cancer happen to younger people. These are not lifestyle choices but they potentially increase your probability of being ill again and could be defined as “pre existing conditions”. Could pregnancy be defined as a pre existing condition? How about not being on birth control is that a “pre existing condition”.

    It seems to me that this bill will leave the definition of “pre existing condition” a bit vague and that sooner or later companies will have definition creep that reduces their risk pool.

    Sounds like a precursor to moving people from medicare to this system.

    Bad idea.

  2. Submitted by Dennis Tester on 01/30/2014 - 10:49 am.

    Still too much government involvement

    After repealing Obamacare, here’s what we should do:

    1. Allow the sale and purchase of health insurance across state lines, just like car insurance is sold now.
    2. Allow the insurance companies to offer as wide a variety of policies as they want, from bare-bones hospitalization-only insurance to Cadillac plans that cover everything.
    3. Allow full tax deductions for all medical expenses of any kind including premiums, co-pays, prescription drugs, doctor bills, hospital bills, etc., regardless of income.
    4. Offer Medicaid to all those who can’t afford health insurance, using the same income standard as used for food stamps.

    It reduces the costs for everyone and it covers the currently uninsured poor people with Medicaid. That’s it. The “republican plan” won’t even pass muster with most republicans.

    • Submitted by Paul Brandon on 01/30/2014 - 12:11 pm.


      You’re recommended a shift from the current state regulation of medical practice to a national health system. Sounds very liberal to me!

      The rest, as usual, favors the wealthy and the private insurance companies (same thing, I suppose).

      • Submitted by Matt Touchette on 01/30/2014 - 05:55 pm.

        Sounds like a Federalist move, not necessarily a liberal one…

        I would argue that Dennis’s suggestion is a federalist move, not necessarily a liberal one. I believe that, while maybe not historically accurate, the current political climate allows for federalists and statists to come from both the liberal and conservative sides of the isle.

    • Submitted by jody rooney on 01/30/2014 - 07:15 pm.

      You are really out of touch Mr. Tester

      You point out the biggest problem with the well to do.

      They have no clue what it takes to survive when you are just getting by.

      You have grossly underestimated the cost of obtaining information.
      So much for easy tax returns. Now people who don’t have deductions have to deal with them not to mention record keeping.

      And how does that solve outrageous pricing for pre existing conditions or end the high bankruptcy rate for people without insurance or with not enough insurance.

      Other than nationwide market areas this is pretty much what we have now.

    • Submitted by Karen Sandness on 02/01/2014 - 10:15 am.

      You seem to have no practical experience with any of these

      1. Sell health insurance across state lines: When I lived in other states, there was extremely cheap insurance available there. The only problem was, it wouldn’t cover anything I had ever had in my life, not even on an emergency basis. For example, there was no coverage for broken bones, because I had broken my arm when I was 11. There was no cover for allergies, not even a life-threatening reaction to a substance previously unencountered. There was no cover for cancer because I once had a false positive on a test. What good is insurance if it doesn’t cover the things that are most likely to bankrupt a person?

      2. They already do offer a range of plans, from high-deductible with lower premiums to low-deductible with unaffordable premiums.

      3. As a self-employed person, I can already deduct my health insurance premiums, This was of no help when I suffered an injury that didn’t meet my deductible and spent months paying off the treatment. Tax deductions next year are no help for a middle-income to low-income person who needs to pay bills NOW. The constant Republican promotion of tax deductions for this and tax deductions for that tells me whose side they’re on.

      4. The ACA already does this.

      Outside the U.S., there are three models of health care: single-payer, where the providers are in private practice and the government pays the bills at a standard rate; national health service, where the providers are public employees but there may be a private option; and compulsory health insurance with the insurance companies on a choke chain.

      In all of these system, medical bankruptcies are unknown. There may or may not be co-pays, but deductibles are unknown. Every legal resident is covered, and even non-residents are given true emergency care and stabilized for transport to their home countries.

      I have lived under quasi-single payer systems twice in my life. When I was in graduate school in the 1970s, the university had a plan for students, employees, and their dependents that covered everything at no extra charge, including maternity care. I knew someone who had an emergency appendectomy and someone else who was hospitalized for a mental breakdown. I knew three graduate student couples who had babies. None of them ever saw a bill.

      I lived in Oregon when the Kaiser-Permanente plan had low monthly premiums and no deductibles. There were clinics all over the city, and while you might not see the same doctor each time, the care was of a consistent standard, since all the providers could access one’s medical records online. I have not had as good or as consistent care since moving back here.

      Many Americans live under the delusion that this is “the greatest country in the world.” Perhaps this idea grew up among immigrants who were impoverished peasants in Europe in the 19th and early 20th centuries and came to find new opportunities. One of the most dangerous parts of this delusion is that what other countries do successfully cannot be replicated here because we’re so all-fired special. It is worth noting that China, once the most advanced and powerful country in the world, began to decline when its rulers decided that they were so far ahead of everyone else that the rest of the world had nothing to teach them. I see us heading in the same direction.

  3. Submitted by Neal Rovick on 01/30/2014 - 10:59 am.

    Last paragraph of the Reason article


    Because the conversation is happening now, following years of blistering attacks on Obamacare, the plan works within the confines of the GOP’s criticism of that law: For political and practical reasons, it’s designed to minimize disruption to the health system rather than transform it, even where bigger disruptions might make for better policy. It’s a necessary and productive starting point, but it also reveals how much the Republican party has limited its options by waiting so long to start talking about its own ideas. The plan sheds some light on Republican ideas about health policy—but also serves as a reminder that those ideas remain in Obamacare’s shadow.

    (end quote)

    I would guess that the key for the Republicans is the first step is the repeal of Obamacare.

    Huzzah’s all around!!

    Then the reinstitution of Obamacare-lite, without the mandate, covering fewer people with more oddball dodgy insurance policies allowed.

    “Entirely different”, the Republicans say.

    How the proposed “plan” works from an insurance standpoint without a large mandated pool, remains to be seen.

    The essential core of the Republican position on health care costs is that most people do not feel enough of the cost of the care and just over-utilize expensive services and do not cost-compare. Sure, raise the personal cost of care and fewer people will utilize optional care items. But there remains the issue of what happens several years down the line on deferred care.

    PCARE–Patient Choice, Affordability, Responsibility and Empowerment

    Choose the plan you can afford, the responsibility is all yours–after all, you are empowered by your income.

  4. Submitted by Hiram Foster on 01/30/2014 - 11:55 am.


    “A big and perhaps surprising difference (given the general Republican attitude to tax increases) is that PCARE introduces a large new tax on those who get insurance through their jobs. Under current law, those employees don’t pay any income tax on the money their employers pay to insure them.”

    I have followed the health care debates for a while now, and this doesn’t surprise me. Many commentators have often said that making health care premiums deductible to employers without making them taxable income to employees is a distortion. There wasn’t a lot of partisanship on that point, and Republicans generally went along with it, and for myself, I understand the point as far as it goes. My questions are these:

    1. Why does it matter whether the tax code is distorted in this way?

    2. Assuming the existence of the distortion, are the costs, if any, outweighed by the economic benefit of making it cheaper for employers to hire workers? At a time where there are all sorts of factors making it expensive and difficult to hire employees, does it make sense, for whatever reason, to make it more difficult and more expensive to hire and retain employees?

    • Submitted by jody rooney on 01/30/2014 - 07:19 pm.

      How about another reason

      Dependence on health insurance supplied by employers makes employees less mobile and that is preventing the free movement of labor. Now that is a distortion.

      Employers should be out of the healthcare business.

      • Submitted by Paul Brandon on 02/02/2014 - 09:46 am.

        And the fact that

        they’re in it at all is an historical aberration.
        It was a way during WWII when wages were effectively frozen to allow another method of remuneration for employers to compete for workers.

  5. Submitted by Richard Voorhees on 01/30/2014 - 12:41 pm.

    Public & Private Corporations

    There is little to distinguish between corporations except to say that portions of each work effectively from time to time. I recently switched medical plans in order to obtain wider out-of-region coverage. It appears that I’m now covered by a vertically integrated corporation that has taken Franz Kafka’s The Castle as a best practices manual. All corporations are intrusive. Public processes are somewhat more accessible. Mr. Snowden has historic company in that regard.

  6. Submitted by Hiram Foster on 01/30/2014 - 12:47 pm.


    “Allow the sale and purchase of health insurance across state lines, just like car insurance is sold now.”

    I have always wondered about this point. Aren’t we deluding ourselves into thinking that isn’t happening now. I know, health insurance companies generally are required to incorporate in states in which they do business, but that amounts to little more than a legal fiction. These local firms are controlled by the national companies who do national business. The practical effect, if not the legal nicety, is that health care insurance policy is set nationally, and therefore is effectively sold across state lines. Getting rid of the legal fictions won’t change that.

    “Allow the insurance companies to offer as wide a variety of policies as they want, from bare-bones hospitalization-only insurance to Cadillac plans that cover everything.”

    The reason that’s problematic is that the costs not borne by bare bones coverage are assumed by the public at large. The bill for their business choices is thrust upon a public who didn’t have any role in making them and doesn’t derive any benefit from them.

    ” Allow full tax deductions for all medical expenses of any kind including premiums, co-pays, prescription drugs, doctor bills, hospital bills, etc., regardless of income.”

    That’s a subsidy for the rich since they are the folks who have the income against which such deductions can be applied. Does that make sense as a tax benefit? Does Mitt Romney really need a tax break?

    “Offer Medicaid to all those who can’t afford health insurance, using the same income standard as used for food stamps.”

    So you stick us with the costs of caring for the poor, while sticking the rich with a tax break?

    • Submitted by Dennis Tester on 01/30/2014 - 04:22 pm.

      Not really

      “The reason that’s problematic is that the costs not borne by bare bones coverage are assumed by the public at large.”

      Why? Catastrophic insurance covers you if you’re hospitalized by illness or injury. It simply means you pay out of pocket for other costs. Surely you can afford the cost of a doctor’s visit.

      “Allow full tax deductions for all medical expenses …” “That’s a subsidy for the rich since they are the folks who have the income against which such deductions can be applied.”

      Why? Anyone who itemizes their taxes would benefit from this. You don’t have to be rich to itemize your taxes. I’ve been itemizing my taxes for 40 years and I’m not rich.

      “Offer Medicaid to all those who can’t afford health insurance, using the same income standard as used for food stamps.” “So you stick us with the costs of caring for the poor.”

      Yup. I’m sticking us with the costs of caring for the poor. How unrepublican of me, eh?

      • Submitted by Tom Lynch on 01/30/2014 - 06:12 pm.

        Re:Not really

        Only 30% of Americans itemize deductions.

      • Submitted by jody rooney on 01/30/2014 - 07:38 pm.

        Mr. Tester you apparently haven’t been sick lately

        You are out of the hospital and into rehab for months. Bye -Bye coverage if you only take catastrophic insurance.

        Have you a clue as to what doctors cost these days $200 -$300 to walk in the door.

        Again many people don’t itemize their taxes. According to the data shown here 60% of the taxpayers to the standard deduction.

        Data from 2005 showed that most Americans don’t itemize deductions

        So now we are going to make taxes more complicated. Not a great idea.

        Do some research before you come up with these costly and grossly inefficient solutions.

      • Submitted by Hiram Foster on 01/31/2014 - 06:12 am.

        Why?Because we are a


        Because we are a civilized people who don’t leave people in need of care to die on the side of the road.

        “Why [are tax deductions subsidies for the rich]

        Because the rich pay more in taxes and therefore benefit more from deductions.

        ” I’m sticking us with the costs of caring for the poor.”

        Let’s not forget that Obamacare was a version of a Republican initiative and the problems it is having are due to features Republicans wanted.

      • Submitted by Pat McGee on 01/31/2014 - 09:02 am.

        Cost of doctor’s visit

        The cost for my doctor’s visit last week was $1,772. Followups to the cause of the visit will run me another $1500. That’s not chump change and it is out of pocket money. My employer upped our deductibles and out of pocket to $6,000 this year.

        • Submitted by Todd Hintz on 01/31/2014 - 12:39 pm.


          I know what you mean. Several years ago I took my wife to the hospital to have her thyroid removed as it was cancerous. Out of pocket it cost us $2000, excluding her follow-up visits, and that’s with good health care coverage from our employer. For us it was a struggle to meet that bill considering we lived on nonprofit salaries, even though we’ve got a solidly middle class lifestyle. I can only imagine how hard it would be for a poor person who doesn’t have money saved up in the bank and is living paycheck to paycheck.

  7. Submitted by Mary Austern on 01/30/2014 - 01:04 pm.

    Obamacare is the Republican’s answer to healthcare coverage.

    In case you and others do not remember, with all the harumphing and flumoxxing that’re going on among Sen. Boehner’s troops, Obamacare is based on a Republican model for affordable health care. Most Democrats wanted and would have preferred a single-payer system, that is, universal care. Clinton couldn’t get that past congress during his term, and so Senators Kennedy and others (Obama included) put together this compromise…the so-called Obamacare.

    Facts become so irrelevant these days, at least in their true historical context. The truth of the matter is that insurance companies and big money wouldn’t allow for universal coverage and so this is what we got…and it’s not necessarily affordable.

  8. Submitted by Neal Rovick on 01/30/2014 - 01:05 pm.

    Quick–shut it down before we lose the impact of sign-up difficulties!!


    Health insurance giant WellPoint Inc. has signed up 500,000 people for Obamacare policies across the country, and it struck an upbeat tone about early enrollment trends under the healthcare law.
    WellPoint, which runs Anthem Blue Cross plans in California and 13 other states, said new enrollees tend to be older than current customers but that enrollment is in line with its projections and pricing for the new policies.
    “We do feel good about what we’ve seen in the exchanges so far,” WellPoint Chief Executive Joseph Swedish said Wednesday during an earnings conference call with analysts and investors.,0,1762698.story#ixzz2ruTaSs00

    (end quote)

    Endless hand wringing about those who had to change their policies because of Obamacare, But hey, toss em off when Obamacare is repealed.

  9. Submitted by Rosalind Kohls on 01/30/2014 - 03:16 pm.

    defensive medicine

    I hope this new health plan includes tort reform. One of the reasons health care is so expensive is that physicians order a lot of unnecessary tests. The tests are not for diagnostic reasons, but so the physician doesn’t get sued.

    • Submitted by Todd Hintz on 01/30/2014 - 06:09 pm.

      Tort Reform

      Malpractice insurance and defensive tests add about 1 – 3% to the overall cost of healthcare, so it’s not exactly sinking the ship. In fact Texas implemented tort reform several years ago and found it had no discernible impact on the cost of medicine in the state.

      I would recommend looking elsewhere for the low hanging fruit in our quest to reform health care.

      • Submitted by Tom Anderson on 01/30/2014 - 08:35 pm.

        1% here, 3% there

        It’s only money. Billions of dollars, but only money.

        • Submitted by Todd Hintz on 01/31/2014 - 07:11 am.


          Considering that Texas didn’t save anything at all I would question whether or not tort reform would get you a ton of money.

          But if you’re really interested in saving billions of dollars, we should take a look at the profit margin of insurance companies. I recommend going with a universal single payer government regulated system, much like our utilities. That will eliminate the profits that insurance companies pull in, saving us a bundle of money.

          • Submitted by Tom Anderson on 02/02/2014 - 09:51 pm.

            That already started

            The companies are limited as to how much money is spent on non-healthcare items

            If, like the utilities, they can ask for and receive a rate increase several times per decade, it sounds like you’re on to something. We can just insert healthcare companies into the headlines instead of Excel and CenterPoint Energy.

  10. Submitted by Ray Schoch on 01/30/2014 - 04:30 pm.

    Thank you

    …Hiram Foster, Mary Austern, and Neal Rovick.

    As long as it remains possible for individuals and families to go bankrupt because of medical expenses, or to die because they cannot afford medical treatment, we’ll continue to have the most pernicious health care system among the planet’s industrialized countries. Mary Austern, in particular, has hit the nail squarely on the head – what Republicans and others who call themselves “conservative” continue to fulminate about is essentially their own plan, drawn up with the full cooperation of for-profit insurance firms, which are not noted for being particularly “liberal.” Those firms will continue to profit under the Affordable Care Act.

  11. Submitted by Dimitri Drekonja on 01/30/2014 - 04:34 pm.

    This “plan” offers very little, and will hurt a lot. Currently, our healthcare system is performing abysmally as a “system”– we have some centers providing outstanding and very costly care for the well-insured, a lot of care (both outstanding, average, and bad) that costs far too much for the insured and under-insured, and many under-insured and uninsured people foregoing care because they can’t afford it.

    The affordable care act was going to address some of these problems– mostly the problems of the uninsured– by getting more (but by no means all) of them into plans, and by making it so that they could no longer be denied from coverage. Under-insurance (and the accompanying foregoing of care and economic hardship) will remain. The cost issue was not really addressed, other than some promises to try hold organizations more accountable, reward innovative care, use electronic records, etc– but no one who is in healthcare who pays attention to these issues sees more than a mild bending of the cost-curve with these things– and we need more than a bend, we need a 15-25% drop to bring us SOMEWHAT closer to the 2nd place country in per-capita spending (Switzerland, last I checked–where they manage to cover EVERYONE). So overall– a bit of good in covering more people, but no real cost-savings because the same inefficient private insurers are involved.

    This Republican “plan” takes away the things that get more people coverage, so removes one of the few bright-spots in the affordable care act. Both plans leave private insurance as the main way people get insured, despite the fact that it is the most inefficient way to deliver coverage, with overhead close to 30% (medicare, ~4%).

    Now that they are suddenly open to tax increases, perhaps there is actually hope for reform that would have a hope of dropping health expenditures by the needed 15-25%: A single-payer plan, open to all, supported by a progressive tax on all employees and businesses.

    • Submitted by Hiram Foster on 01/31/2014 - 08:23 am.

      Obamacare with it’s markets and it’s dependence on private sector insurers is a Republican plan. Democrats, if we had our way, would have done something different. But since Republicans reflexively oppose anything the president does, they were forced to reject the Republican program, Congress and the president eventually enacted.

      Going forward, Republicans have refused to enact an alternative plan. They have voted 42 times to repeal Obamacare, but have been unable to enact even one alternative. A basic reason for that is that they have been unable to agree among themselves that would meet the impossibly high standards for the president’s program.

      • Submitted by Hiram Foster on 02/01/2014 - 08:28 am.

        Republican plan

        Since Obamacare adopted Republican health care principles to such a large extent, and since it must be reflexively rejected in total, Republicans placed themselves in a very difficult. So many of their favorite ideas were coopted in the president’s plan, it has become very difficult to craft any sort of proposal from the shards of GOP health care policy that’s left. The heart of their proposal, right now, is to subsidize the individual purchase of health care insurance. Obamacare does this too, but Republicans believe that if you put a different label on a package, you can persuade people that what’s inside is changed too.

        For me, what’s fascinating is how this Republican proposal relates to a larger issue which we are aware of but have stopped way short of exploring. We all know Congress is dreadfully unpopular, and a big reason for that is that it can’t do anything. What is hardly examined at all is what this means. Since Congress is dysfunctional, we must understand that any proposal of any kind which depends for success on Congress being functional and effective is doomed to failure. Obamacare addresses this problem by being self financing. It doesn’t need further Congressional action in order to work, a pretty huge deal. And this is the flaw with the Republican proposal to subsidize the purchase of private health insurance. Quite simply, Congress cannot be counted on to increase the subsidy to keep pace with inflation. We know this will happen, or not happen, I should say, because that’s characteristic of legislative bodies. It’s why the minimum wage hasn’t been raised in years.

  12. Submitted by Lance Groth on 01/30/2014 - 05:18 pm.


    No protections for preexisting conditions = nonstarter. No need to even consider the rest as long as the people who need insurance most are excluded.

    • Submitted by Todd Hintz on 01/31/2014 - 12:29 pm.


      As far as I’m concerned any legislation that doesn’t start with universal coverage needs to be automatically rejected. Throw the bill in the trash, start over, and don’t come back till you have at least that basic element covered.

  13. Submitted by Tom Anderson on 01/30/2014 - 08:38 pm.


    It is AN alternative, not THE alternative. Complain about no ideas, complain about the ones offered. At least this plan won’t be jammed onto the populace in a month or so and then we can find out how it might work.

    • Submitted by Neal Rovick on 01/31/2014 - 07:44 am.

      ….jammed onto the populace in a month or so…..

      Gosh, you are so right. Obamacare was invented practically overnight and passed faster than any other major piece of legislation in history.

      And the previous decade or two provided no opportunity to address the issue, either.

  14. Submitted by Matt Haas on 01/31/2014 - 06:10 am.

    I use the same barometer for this as I do all proposals

    Will my 10 year old niece, who has CF, be covered by it without needing to turn to charity. Would appear to be no in this case. So not acceptable. Is my analysis biased and probably myopic, sure, but as it pertains to per existing conditions its very relevant, and frankly if someone doesn’t like it I don’t particularly care.

  15. Submitted by Neal Rovick on 01/31/2014 - 07:50 am.

    Well, the “read my lips-no new taxes” crowd woke up and now the tax will placed above “65% of the average expensive, high end plan”–whatever that is.

    The effect of this change is clearly less revenue to cover the costs for those who can’t afford it–resulting obviously in fewer people covered, and worse insurance options.

  16. Submitted by Paul Udstrand on 01/31/2014 - 08:47 am.

    This just a rollback

    This is just a rollback with a little extra thrown in for employers. It just demonstrates the fact that Republicans don’t believe there ever really was a problem with health care. We have a health care market, people make money, what more do you want?

  17. Submitted by Dennis Tester on 01/31/2014 - 09:30 am.

    See …

    this the panicky reaction you get from a citizenry that has been conditioned away from self-reliance and fully expects to be taken care of by someone else. What a sad condition this nation has become.

    • Submitted by Paul Brandon on 01/31/2014 - 01:44 pm.


      Innumeracy and illiteracy are rampant.

    • Submitted by Joel Fischer on 01/31/2014 - 04:52 pm.

      No man is an island,

      Entire of itself,
      Every man is a piece of the continent,
      A part of the main.
      If a clod be washed away by the sea,
      Europe is the less.
      As well as if a promontory were.
      As well as if a manor of thy friend’s
      Or of thine own were:
      Any man’s death diminishes me,
      Because I am involved in mankind,
      And therefore never send to know for whom the bell tolls;
      It tolls for thee.

      -John Donne

    • Submitted by Jon Lord on 01/31/2014 - 05:25 pm.


      All those poor people who can’t afford insurance depending on the government to take care of their health problems?? Oh how it hurts all those rich people who don’t want to pay a decent wage! All those companies who can’t afford to hire people because people want to be paid enough to afford health care. I mean…how self-reliant can one get by not having work? Or a decent wage? Or health care? Isn’t it terrible what poor people want? They even want food!! It’s such a shame that they want a decent life…Say it ain’t true bubba!

      • Submitted by Paul Brandon on 02/01/2014 - 10:00 am.


        Real wages have gone down as health care (and other) costs have gone up.
        And, of course, corporate profits.

    • Submitted by jody rooney on 02/01/2014 - 08:59 am.

      And your tax deductions are?

      Stop taking deductions which are subsidies and then after having removed the log from your own eye (i.e. not dependent on government subsidies) you may have some credibility to talk about removing the speck from someone else’s eye.

      Does the word hypocrisy mean anything to you?

    • Submitted by Todd Hintz on 02/03/2014 - 07:28 pm.

      Give It a Try

      Self reliance will not cure your cancer or set your broken bones.

  18. Submitted by Karl Sonneman on 01/31/2014 - 04:54 pm.

    Reality of markets

    We need realism in any discussion of markets. The health care “market” does not work like other markets. When you are sick, you want to get well. If you need an aspirin, you will probably buy the aspirin without asking price. If you have a heart attack, the ambulance will take you directly to the ER and there will be no discussion of price. The bills will only come later. If you get cancer, you will seek a cure regardless of the price. The only issue will be where you can get enough money to pay. If you accept death before bankrupting your family, your family probably will urge you to get cured and worry about the money “later”. If you do not get adequate treatment for disease, it is most likely because you do not have enough in your bank account and not because you would not choose to send the money to get well. We like having health insurance if the cost is seen as indirectly borne by us, but may choose not to pay directly for insurance because we think we will not get sick. Then when we get sick, we still believe we should get well and medical care will and should be there to accomplish this. So ends a rational market interaction for health care.

    If the market were limited to elective surgeries, the sniffles and health check-ups, the argument of market might have some weight. However, even here we know that preventative care can save significant sums in the long run when we end up in the non-functioning end of the market. It pays to pay people to take steps to stay well in order to avoid the costs of serious diseases.

    • Submitted by Jon Lord on 02/01/2014 - 09:14 am.

      Yes we don’t take into account

      Who sells the foods that are deemed unhealthy? How long have they been doing it? When was it determined those foods were unhealthy? There used to be an ad on TV that stated “4 out of 5 doctors agree smoking aids digestion!” Asbestos was determined in England to be hazardous to a person’s health close to 50 years before the US decided it was. DDT was sprayed on our crops indiscriminately before it was determined to be unhealthy. Questionable meds are even now touted over the airways. The quality of our air and water, etc, remain questionable. All add to health problems that can’t and couldn’t be foreseen by the public at large. Reality is a very broad brush.

  19. Submitted by Paul Udstrand on 02/02/2014 - 10:22 am.

    It doesn’t matter anyways

    This plan will never replace Obamacare and it will drive the Republican party even further into obscurity.

  20. Submitted by Paul Udstrand on 02/04/2014 - 10:34 am.

    Tort reform and tests

    The misconceptions behind republican “plans” are legion. Dr.’s don’t order tests in order to protect themselves from law suits. Test are ordered for two reasons: 1) They make sense medically. 2) This is how health care providers make money.

    All tort reform would do is limit a patients ability to collect damages, it protects the provider’s revenue, nothing else. If you really want to do something about the lawsuits make health care universal and affordable. The majority of health care lawsuits are driven by financial hardship, people can’t pay their bills because of medical costs. That’s why countries with universal care have a fraction of the medical lawsuits we do in the US.

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