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On the CBO projections — and what the Senate’s health bill reveals about Republican preferences

REUTERS/Aaron P. Bernstein
Senate Majority Leader Mitch McConnell

I haven’t bothered railing at the Senate Republicans for crafting their McConnell/Trump health care bill in secrecy with no opportunity for input from Democrats (or even from most Republicans). We’re past the point where there’s much hope for compromise across party lines. The bill is nowhere near ready to become law, and most of us (certainly I) would need guidance from the Congressional Budget Office (CBO) to know how it differed from the existing Obamacare program and from the House version (which I call Ryan/Trumpcare).

So the draft of the bill is now out, and so is the CBO score. According to the CBO analysis, if the Senate bill becomes law and takes effect, by next year the ranks of the uninsured will grow by 15 million in the short term and then will keep rising to 22 million additional uninsured Americans in 2026. That’s compared to 23 million for the House version, which President Trump first hailed and now calls “mean,” presumably because of the rise in the uninsured. On that basis, the Senate bill is 4 percent less mean.

In other words, according to my lights and my values, both bills are (to steal from the title of the Judith Viorst book about Alexander’s day, “terrible horrible no good very bad” bills. But that’s just according to my values, and perhaps some among you likewise feel that reducing the ranks of the uninsured is a higher priority than cutting taxes for millionaires and billionaires. A bit more about that below.

‘Mandate’ would go

In the interest of fairness to the Republican approach, it should be noted that a large share of those who will end up uninsured will do so voluntarily, in a sense, because both Republican versions repeal the “mandate” contained in the Obamacare law that required most people to obtain insurance or else pay a penalty. At least according to standard conservative rhetoric, this mandate offends the conservative/Republican belief in “freedom,” in this case the “freedom” to be uninsured.

The hot-off-the-presses Senate version adopts a new approach to discourage people from going without health insurance. If you were to choose to go without coverage, and then try to get insurance after you got sick, the Senate version would allow insurers to refuse to cover you for up to six months. So your “freedom” to be uninsured bleeds right into the insurance company’s freedom to deny coverage to the already-sick. I’m not sure how to score this on a relative meanness basis. Perhaps Trump will enlighten us.

In the next few days you may hear some ritualistic Republican denunciations of the CBO score on the grounds that the CBO can’t really see the future and many of their past efforts to project the 10-year future of a proposed new law have turned out to be incorrect.

That is, of course, true. You could say the same about all the right-wing think tanks that Republicans prefer or left-wing think tanks that Democrats prefer, which will also try to describe the likely future impact of the bill. No one (other than Carnac the Magnificent) can accurately predict the 10- or 20-year future of such a complex matter. Everyone will get it wrong to some degree, and that includes the CBO.

CBO produces the best analysis we have

But the CBO is the best we have. It is a nonpartisan, nonideological outfit that works for Congress and was created expressly for this purpose: to analyze and project the future cost and impact of proposed legislation. And, like every other nondeity, its vision of the future will be more or less inaccurate. If you don’t like what it projects, you can dismiss it on that basis, but your motives for doing so will come into question.

The Washington Post, in its coverage of Monday’s CBO score, anticipated the inevitable whining about the score and included this paragraph:

“The CBO has been regarded over its four-decade history as a source of neutral analyses devoid of political agenda. Its current director, Keith Hall, is a conservative economist who served in the administration of President George W. Bush and was appointed to his current role two years ago by a Republican Congress.”

The New York Times decided to run a sidebar feature on CBO chief Hall that portrayed him as the most apolitical of number crunchers and said:

Congress intended the C.B.O. to serve as a nonpartisan provider of cost estimates and economic forecasts for nearly every piece of legislation that Congress considers. That makes the agency a lightning rod of criticism for both Republicans and Democrats when it says bills are going to be more costly to taxpayers than politicians had indicated. These days Mr. Hall and the credibility of his office have been under especially intense scrutiny because of the C.B.O.’s damning assessments of the health care bill that Republicans have been struggling to pass this summer.

Will it pass?

Two more bits of prognosticating, which the CBO won’t do but the punditocracy will, is whether the bill can pass and become law and whether the passage will help or hurt Trump and Republicans in their future endeavors to win elections. Nobody knows that either, and I won’t engage in it, but prepare to hear a lot of predicting and punditocratizing along those lines. (No, that is not a real word.)

If you haven’t figured it out yet, the often smart, well-intentioned people on those news panels who speculate on the future of such matters don’t know the future either and know even less than they used to think they knew before the year of Trump.

Here’s my view: I’m for single payer. The countries that have it (like Canada, but there are many others) have demonstrated that you can get the uninsured share of your population down to almost zero, spend less of your GDP on health care, and get significantly better results than the United States does in measures such as life expectancy and likelihood of dying of various treatable diseases. But it’s very bad for the for-profit insurance industry and other highly compensated players in the health care business. As a result, we may never be able to find out how well it would work in the United States. It might not work as well here as it does in Canada, for various reasons. But it definitely reduces the portion of the population that lacks access to health care.

I’m no expert on health care policy. I’m so simple-minded about it that I think reducing the share of the population that can’t get good health care should be one of the primary goals of a national health care policy. Republicans clearly disagree.

‘Revealed preferences’

On that score, I found very clarifying this piece by New York Times columnist Neil Irwin, who often focuses on economic news and economic thinking. It’s headlined: “The Health Debate Shows What Both Parties Care About Most.” Irwin introduces us to the economic concept of “revealed preferences,” which suggests that you reveal what you care most about less by what you say and more by what you do.

President Barack Obama and his partisan allies in 2009-10 cared more about reducing the uninsured share of the population than they cared about keeping taxes low on millionaires and billionaires and keeping profits high in the insurance industry. So their law raised taxes on the wealthy and increased regulations on insurers and doctors and hospitals all in ways that were designed to reduce the uninsured share of the population. And they succeeded in cutting that share roughly by half.

If you look at it from a “revealed preference” perspective, the Republicans in Congress care more about cutting taxes for the wealthy and improving the profit picture for insurers, and they are willing to uninsure millions of mostly poorer Americans to achieve that goal. That, quite bluntly, is the big tradeoff that both the House and Senate bill make.

Here’s another crack at that link to Irwin’s piece. I recommend it and wonder if you will likewise find it not surprising but clarifying. He notes that thanks to the various ways that the Republican bills reduce spending on health care, they are able to repeal wealth taxes that Obamacare imposed to make health care more affordable for the nonwealthy. He notes, for example, that, if the Republican passes:

A 3.8 percent tax on investment income over $250,000 for a couple would be history, as would an 0.9 percent surcharge on payroll tax above that same level. The Tax Policy Center estimates that would amount to an average tax cut of $54,000 for households making over $1 million.

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Comments (74)

  1. Submitted by Gene Nelson on 06/27/2017 - 11:18 am.

    28,000 to 100,000 will lose their lives each year

    According to an article in the LA Times, 28,000 to 100,000 people will lose their lives each year.
    Ahhh….but the wealthy will receive a $700 BILLION tax cut over the next decade.
    Easy to see repub priorities.
    http://www.latimes.com/business/hiltzik/la-fi-hiltzik-repeal-deaths-20170623-htmlstory.html

  2. Submitted by Paul Udstrand on 06/27/2017 - 01:11 pm.

    No surprise

    The Republicans simply have no coherent concept of health care, and little if any real concept of economics in the real world. Furthermore, Republicans have never believed that we actually had a health crises or even a serious problem in the first place. As long as we have “free” markets it’s simply not possible to have a health care problem… they believe.

    Obamacare was a neo-liberal “solution” dating back to Republican plans in the late 1980s. Obamacare was a “market” solution or “fix” that as such, cannot control costs or provide universal coverage. Even with Obamacare left completely intact, notice that the CBO projects 28 million American’s will still be left without affordable access to health care.

    The only difference between neo-liberal Democrats and Republicans is that Republicans don’t believe markets ever really NEED to be “fixed” because they’ll fix themselves. That’s what the repeal of Obamacare is really about, the Republican delusion that they’re returning the “market” back to some kind of natural state where it will fix itself.

    Beyond that there is also a clear moral bankruptcy inherent in the Republican mindset because unlike neo-liberals, reactionary conservatives much are less concerned about inflicting any kind of suffering upon human beings. For reactionaries suffering is part of life for those who earn it by not being wealthy enough to avoid it. Neo-liberals will tolerate some extreme suffering around the edges but reactionaries like Rand Paul will actually build cruelty into the system if given a chance. What’s weird is the fact that Republicans still have to win elections. Granted, they’ve won despite their sociopathic nature several times in the past but this is getting ridiculous. Even if they get this passed, it will kill them eventually.

  3. Submitted by Tom Christensen on 06/27/2017 - 11:41 am.

    A REPULSIVE fact not to be lost about this disasterous bill

    No women were included on the committee or given the chance to participate in the decision making, true to GOP form. No women included and yet, many aspects of the bill will have a huge impact on women. I find it brain numbing to see how little respect the GOP has for the women of America. Half of our population disregarded because they don’t have any value in our society according to the GOP. It is Okay to grab them by the you know what but it’s not Okay to protect their lives – REPULSIVE.

  4. Submitted by Neal Rovick on 06/27/2017 - 11:45 am.

    While “insider” Tom Price and “motor-mouth” Kellyanne Conway are adamant that there are no cuts in Medicaid–the nearly $800 billion in tax cuts comes from directly from cuts in Medicaid. As you were discussing lies by Trump before, these are as magnificent a lie as any that Trump himself has told. By 2026, according to the CBO, there will 15 million fewer people on Medicaid (with 11 million being those who were never under the Obamacare Medicaid expansion). I don’t think that fairy-dust “free medical care” will come into play.

    It is interesting how this will tie into Minnesota’s tax revenue situation–for all of the MNGOP angsting about tax-cuts of their own, if this or similar passes, there will be no surplus of any nature for the foreseeable future, and the state/county medical provider systems will be in jeopardy of survival–especially in the older, low tax-revenue, underpopulated rural areas of Minnesota. Good luck squaring that circle, GOP outstate !!

    I have read scenarios where once the bill passes the Senate, there will be very little reconciliation with the House, and this bill could be law in a matter of weeks after Senate passage. We’ll see if the truism that “GOP moderates always cave to leadership” holds true here because you certainly can’t count on Paul and other “less is better” crowd. They’re too easy to please.

  5. Submitted by Misty Martin on 06/27/2017 - 11:54 am.

    I remember that book, Eric.

    It was a very good children’s book by the author, Judith Viorst, and I enjoyed reading it to my children way back when. I don’t enjoy having to live out the last two years as some of the VERY WORST in my entire life, however, with no light at the end of the tunnel.

    My husband, a diabetic, has been sick for some time. He lost his job as a coal lab technician over two years ago, when he was laid off and we lost our health insurance. We both have health issues that need addressed, but I was hoping and praying that if my husband received his SSA DIS benefits, we could afford some type of health insurance to get us through at least until we qualify for Medicare. I am working, but my income is not enough to hardly cover our most basic needs and monthly bills and my job does not include health insurance. Now I see absolutely NO LIGHT at the end of this very dark tunnel.

    My husband was recently turned down on his SSA DIS because he chose to work while sick instead of quitting before he was laid off, and now they believe he could still work as a baker’s assistant if need be (there are NO baker’s assistant positions available in our area) and even though we cannot afford his diabetes medications most months, and his diabetes is now out of control, the SSA ALJ still believes he could find and hold a job. He has worked all of his life, and this seems to go against him now trying to receive the disability benefits he deserves at this stage of his life. It seems it would almost have been easier to obtain disability benefits if one NEVER had worked at all. And the new budget plan in the works, will make it harder than ever for anyone to try and obtain SSA DIS, according to what I have read, with the cuts planned for Social Security benefits.

    And so, NO, I am not for cutting taxes for the millionaires and billionaires out there, while thousands of deserving people, some of which, cannot help the misfortune of being poor and sick, are deprived needed healthcare. But I’m not surprised – at least not from this administration. It just sickens me more than I already have been since the results of our Presidential election in November of 2016.

  6. Submitted by John Appelen on 06/27/2017 - 01:01 pm.

    Simple

    Per Eric’s summary, it does sound simple… Obama etal wanted to lower the number of uninsured and they were happy to charge the wealthy and most of us other tax payers to do so. (ie heroes) And the GOP wants to reverse that. (ie villains)

    Now I have always seen benefits and detriments to ACA, however I am fascinated with the idea many here hold that for some reason successful citizens should be forced to pay a LOT more so that it can be given to unsuccessful citizens.

    I mean let’s reverse Eric’s closing paragraph. “The TPC estimates that ACA incurred an average tax increase of $54,000 for households making over $1 million.”

    Does anyone here think that sounds wrong? I mean are not talking about building bridges, roads, providing national defense, or anything that is of value to all citizens. We are talking about taking money from the “Peters” so it can given directly to the “Pauls”.

    And this is on top of an already progressive tax code.
    http://www.pgpf.org/budget-basics/how-much-do-americans-pay-in-federal-taxes

  7. Submitted by John Appelen on 06/27/2017 - 01:17 pm.

    Also

    Why do folks here feel so strongly that providing healthcare and social services is a duty that NEEDS to be fulfilled by the Federal Government instead of the individual States?

    Personally I prefer leaving the care of Minnesotans to us Minnesotans. No sense sending the money to Washington DC just so that they can send only part of it back to us… Thoughts?

    • Submitted by Tim Smith on 06/27/2017 - 01:58 pm.

      Amen Sir!!

      we did a great job prior to ACA and can do it again.

      • Submitted by RB Holbrook on 06/27/2017 - 03:04 pm.

        What?

        Who did a “great job” prior to the ACA?

        I thought this discussion was about health care in the United States.

        • Submitted by Tim Smith on 06/27/2017 - 06:02 pm.

          Ha?

          Minnesotans

          • Submitted by RB Holbrook on 06/28/2017 - 10:12 am.

            I See

            Minnesotans, and only Minnesotans. That’s a great way to build national unity.

            • Submitted by John Appelen on 06/29/2017 - 11:29 am.

              Unity

              I wonder if national unity is supported when people from the urban areas / states are empowered to force their values on people in rural areas/ states with the one size fits all program?

              Or will unity be improved by letting each of the 50 States develop policies and systems that work for their population. Thus honoring the freedom of the people from each state to live as they wish, and to help their neighbors as they deem best.

              I come from a family with a controlling and demanding Father who is certain he is correct. I have never felt that his desire to force compliance has led to greater unity.

              • Submitted by Karen Sandness on 06/29/2017 - 10:09 pm.

                If TrumpCare is instituted, it will be precisely

                those “self-reliant” rural “values voters” who will suffer the most.

                They have fewer medical choices to begin with, and they are much more likely than people in the cities to need Medicaid for nursing home care.

                • Submitted by John Appelen on 06/30/2017 - 01:54 pm.

                  Interesting

                  My farming and construction friends have had to pay far more since ACA was introduced. In fact one of them finally chose to give up coverage. Please remember that ACA mostly helped those with low incomes. Others had to pay more to compensate.

      • Submitted by Harris Goldstein on 06/27/2017 - 07:24 pm.

        Ah, the good old days. Can you provide us with a definition of what you consider doing a great job?

        Do you mean that none of the folks you considered friends were without healthcare insurance? Did you ask (back then) the store clerk, the dishwasher at your favorite restaurant, the person picking sugar beets in the Red River valley, the home health attendant, the car wash attendant?

        (Mea Culpa, I didn’t either. But at least I know these people exist.)

        I’m sure that, as you make that statement, you recognize that many full time jobs with benefits have been shifted to part time jobs without benefits. And that the minimum wage has been losing purchasing power. And that medical bills were a leading cause of bankruptcy. And that people were routinely denied coverage for pre-existing conditions. And that some people had policies that excluded the very health conditions most likely to create great financial hardship.

        And the premise – to which you shouted “amen” – that the state will take care of these unsuccessful folks is laughable. The very same people who wish to deny them the opportunity for healthcare at the federal level will do the same at the state level.

        I think my 70s health insurance was great. HMO with no deductible, no out of pocket, ready availability of physicians. But those days ended way before the ACA.

    • Submitted by Connie Sullivan on 06/27/2017 - 02:04 pm.

      I’m just trying to get my head around John Appelen’s concept of the “unsuccessful citizen.”

      They are the human beings that have gotten old and frail and unable now to care for themselves and have exhausted all their retirement savings on health care and nursing homes, so they’re surviving on Medicaid. With the GOP plan, their Medicaid benefits would be “capped,” meaning that after a certain time, the nursing home will have to throw them out on the street. To die alone and uncared for (only emergency medicine includes the must-provide-care expectation, not long-term care facilities).

      Or think of the “unsuccessful citizens” who are children. Forty percent of American children only get health care through Medicaid. If a child is born with a congenital defect or illness, should we “cap” their health benefits and just let them die? Or, should we just let them die at birth, once their defects have been discovered?

      What about all the pro-life folks who would prefer not to provide healthcare for pregnant women or women as they go into childbirth. The Senate GOP “plan” permits states to omit coverage for that from so-called healthcare policies, so any woman or family that thinks of having children had better be ready to cough up some $10,000 for one birth!

      “Successful citizens” seem to be those who can afford a medical bill of tens of thousands of dollars, without recurring to help from insurance plans. The rest of us, to the GOP, are dispensable.

      The difference between the GOP and the Democratic way of addressing health care is that the Democrats believe that ALL of us deserve healthcare. The GOP bills in House or Senate do not provide health care.

      They provide tax cuts on passive investment income for the wealthy.

      I just don’t understand the inhumanity of that approach.

      • Submitted by Neal Rovick on 06/27/2017 - 04:44 pm.

        It’s the “science” of eugenics based on money.

        Money = success = superiority = God loves you better than all the rest.

        Not much deeper than that.

        But in a “folksy” way.

        Thoughts ?

        • Submitted by John Appelen on 06/28/2017 - 08:38 am.

          Or Does…

          Learning + Working + Saving + Investing + Good Choices = Self Sufficiency

          I have no problem taking care of the truly needy and disabled however it seems our public policies have failed if that is now ~20% of our population.

          And I always love that “someone is going to toss Granny out of the home”… Where is Granny’s family? Do you really think the State officials, Local officials and charities will let that happen?

          Back to my original question… Why does it need to be the Feds?

          • Submitted by Neal Rovick on 06/28/2017 - 12:21 pm.

            Why the Feds?

            Because the exact same attitude plays out even more strongly on the state and local jurisdictions and it also takes even fewer powerful people to cause damage. Accident of birth, accident of local economy, accident of demographic cycles, etc and all that…

            It’s called the “United States”, after all.

            And

            Learning + Working + Saving + Investing + Good Choices – accident or major illness = bankruptcy

            How about them apples–that’s what insurance is about.

            Thoughts….?

            Or none…?

            • Submitted by John Appelen on 06/28/2017 - 12:56 pm.

              Good Choices

              I am thinking that living healthy, staying insured and paying one’s premiums are some of those good choices from my formula.

              I think living unhealthy and taking significant financial risks, like not paying one’s insurance bills, would be deemed “making poor choices”.

              Now when you succeed into turning the USA into a national democracy instead of a union of states… Should we rename the country to be more accurate?

          • Submitted by Larry Moran on 06/29/2017 - 08:43 am.

            Feds vs. States

            I’ve never understood why something vital to citizens (like healthcare) should be different for different people depending on the accident of where they live. If we leave providing healthcare to those unable to afford it to the states it’s very likely that care will be significantly different depending on where you live. MN may decide to provide great coverage to its citizens in need, while TX or LA may choose not to provide the same level of care. Should your life expectancy, or more likely the quality of your life, depend on your zip code? In answer to Mr. Appelen, isn’t this issue exactly what the Feds should be doing? If we depend on the Feds to protect us from attack by our enemies, shouldn’t they also protect those in need from suffering due to a lack of healthcare?

            • Submitted by John Appelen on 06/30/2017 - 12:09 am.

              Maybe

              I guess I see it a bit differently, I see medicaid and health insurance subsidies as just a different form of welfare. For some reason supporters see healthcare as more of a right than food, housing, clothing, etc since they get excited about applying work reqts to medicaid. Maybe it sounds more glamorous and acute…

              Now Liberals seem to have a belief that “someone” owes everyone in America healthcare, food, housing, a cell phone and likely some spending money no matter the choices made or effort undertaken. Which of course means that those who learn, work, save, stay married, invest, etc are rewarded for being good productive citizens by having to pay progressive tax rates so the money can be given to others who live differently. And worse yet as noted in some comments here, many Liberals expect nothing from the recipients in exchange for the gift they are given by our tax payers.

              So no, I think these policies are best left to the people of the states. If California wants to have very progressive tax rates so money and services can be handed out rather indiscriminately, they should be free to do so. And if SD wants to keep taxes and services low, they should be free to do so. And the people of America can then move to the State who’s policies are aligned with theirs.

      • Submitted by Misty Martin on 06/28/2017 - 08:42 am.

        Thank you, Constance,

        I don’t understand the inhumanity of that approach either. Back when both my husband and I were in good health, and we both were working decent jobs (considering the job market around here where we reside) and we were both covered by health insurance through my husband’s employer (that while not great, was still decent for the percentage we had to pay per month) I never foresaw that we would be classified as some of the “unsuccessful citizens” here in America. We both worked hard – we were trying to help pay for college for our two sons, so that they could have a better life than what we had while growing up (we both came from lower class families) who worked hard, but never seemed to get ahead.

        And now, here we are, both having health needs and no insurance and faced with the inhumanity of those who are in power who do not have to decide whether they will eat, buy medicine or pay the mortgage this month.

        • Submitted by John Appelen on 06/28/2017 - 11:19 am.

          Who

          Misty,
          Who do you think should pay for your “food, medicine, mortgage”?

          Please remember that the government make NO money… Whatever they give has to be taken from other citizens. What is your rationale?

          What should or can the recipients of this tax payer generosity do to earn it? Or to reduce their reliance on it? Should their be a limit to these gifts?

      • Submitted by Paul Udstrand on 06/28/2017 - 09:12 am.

        Like I said…

        Reactionary conservatives/Republicans never “believed” there was a problem or crises with health care in the first place. John and Tim are merely confirming that observation, we had a market, people were making money, what more could you ask for?

        Not only do Republicans not believe there was a pre-Obmacare crises, their mentality actually cannot recognize such a crises as a matter of pure faith. The only “crises” the Republican mentality can recognize are usually manufactured crises like “entitlements” or “taxes”. They’ve simply disconnected themselves from reality… Rove et al actually coined the term: “reality based community” to describe those who don’t share their mentality.

        Of course it’s all incoherent gibberish and magical thinking, and when THEY find themselves filing for bankruptcy because of a medical catastrophe it’s always someone else’s fault, but hey, that’s what personal responsibility is all about.

        And yes, this is a morally bankrupt mentality that considers anyone who can’t afford private insurance to be a failed citizen. These people don’t even really have a coherent concept of citizenship let alone health care.

        • Submitted by Pat Berg on 06/28/2017 - 10:55 am.

          They’re against it until they need it

          Reality sinks in:

          “This Former GOP Congressman Loathed Obamacare — Until He Lost His Own Coverage”

          http://www.huffingtonpost.com/entry/david-jolly-obamacare_us_59529e05e4b02734df2de1be

        • Submitted by John Appelen on 06/28/2017 - 11:12 am.

          Problem

          I think there are many problems in America that have made it difficult for people to pay for their healthcare:
          – Many citizens failing to learn in our public schools. (due to both school and parental failings)

          – Many citizens buying their goods and services from over seas manufactures to save themselves some money. (ie under cutting good American jobs)

          – Many citizens supporting illegal workers living and working in the USA.

          – Many citizens supporting burdensome regulations and oversight that make it hard to do business in the USA. Thus costing us jobs.

          – Many citizens are now over weight, obese or participating in other high risk / unhealthy life styles which greatly increases the country’s medical costs.

          – Many citizens sue Doctors and Healthcare organizations and juries give large settlements.

          – Other

          The combination of all these things have made it difficult for many citizens to be self sufficient and afford health insurance premiums. And unfortunately ACA does little about any of them. All it does for the most part is change “who is paying the bill”. The many citizens get to keep making questionable choices and the few foot the bill.

          • Submitted by Paul Udstrand on 06/28/2017 - 01:26 pm.

            Too bad…

            It’s too bad the actual affordability and availability of health care didn’t make your list, but this IS a good list of the most insignificant and/or imaginary contributors (illegal aliens have almost nothing to do with our health care costs). Again, this is why Republicans simply cannot deal with health care in any coherent way, when they try to make a list of the problems with health care… we get a list that has everything… but health care. Say goodnight Gracie.

            • Submitted by John Appelen on 06/28/2017 - 02:38 pm.

              The Problem Statement

              You are limiting your problem statement too much. The USA actually has the most technically advanced and readily available healthcare system in the world. That is why so many wealthy people from all over the world flock here for care. And why so much of the world’s population uses medicines, techniques, implantables, diagnostic equipment, etc that were developed here. So healthcare quality and availability / timeliness are not our problem.

              It is that third leg of the stool that is the problem, we have a very expensive system and some people can not afford to pay the premiums / bills necessary to use it. So there are 3 options:

              1. Reduce the costs (ie people live healthier, new technologies, eliminate waste, etc)

              2. Reduce the profit incentive built into our system.

              3. Raise the income of those who can not afford the premiums to the level where they can.

              I think #1 & #3 is the simplest options with the least potential for negative unintended consequences.

              • Submitted by Paul Udstrand on 06/28/2017 - 03:01 pm.

                No….

                ” The USA actually has the most technically advanced and readily available healthcare system in the world. ”

                That’s simply a false claim and you can’t build any coherent thesis from that premise.

                • Submitted by John Appelen on 06/28/2017 - 07:02 pm.

                  Where else in the world would you rather take your very sick child or other loved one than a world renowned US hospital?

                  And we are very fortunate to have mayo in our back yard.

                  • Submitted by Paul Udstrand on 06/29/2017 - 08:51 am.

                    Mayo…

                    There are world renowned hospitals… all over the world. And you can only get into Mayo if it’s in your network of care providers or if you can afford go outside your network.

                  • Submitted by RB Holbrook on 06/29/2017 - 09:58 am.

                    Look at the Outcomes

                    The US does well on the dazzling, impress the crowds type of medical care.

                    On the other hand, for all the money that we spend on our health care, the US ranks 42nd for life expectancy at birth, and 56 other countries (including Cuba) have lower rates of infant mortality.

                    • Submitted by Paul Udstrand on 06/29/2017 - 10:34 am.

                      Yeah…

                      Aside from cost I don’t think we’re in the top ten of any relevant health care metric. And the “dazzles” aren’t accessible to the vast majority of American’s. Frankly, the quality of our “dazzles” is more of a product of marketing than reality anyways. In the last few years the US has actually fallen behind in terms of medical innovations and advances, mainly because we’ve been cutting NIH funding and funding for general research at our universities. While researchers in other other countries are producing breakthroughs, we’re producing slightly different antihistamines or cholesterol meds that make money as new name brand treatments but don’t actually work any better than previous generations.

                    • Submitted by John Appelen on 06/29/2017 - 11:21 am.

                      Affordability

                      RB,
                      As I said above… We do great on quality and availability / timeliness…

                      It is that third leg of the stool where the issue resides, so we need to:
                      – decrease costs and/or
                      – increase household incomes

                      To do anything else is just moving the payment between citizens. And unfortunately this is mostly what ACA did.

                      And regarding Paul’s comment below.

                      Anyone can go to Mayo if they have insurance (ie in network) or they have money. Thus bringing us back to this being an affordability issue.

                    • Submitted by RB Holbrook on 06/29/2017 - 02:51 pm.

                      “Get Me Hamm on Five, Hold the Mayo”

                      Health care is not available if it is not affordable.

                      “Moving the payment between [among?] citizens” is another way of describing insurance.

                    • Submitted by John Appelen on 06/30/2017 - 09:53 am.

                      However “being affordable” can be addressed by increasing American incomes or reducing healthcare costs. Now are Americans ready to pay more to buy American, deport illegal workers, etc to raise American incomes?

                      And insurance is usually a good way for people to pool money and reduce risk. Unfortunately the Liberal plans want to have some people put vast sums of money in the pool while others put none. It is a pretty good deal for the non-contributors.

                    • Submitted by Robert Gauthier on 06/30/2017 - 02:43 pm.

                      Your opinions

                      Seem to be based on an ideological basis that looks good theoretically but does not hold up in the real world.

                      To whit:
                      “Insurance is readily availabeif you want to work for it” There are massive numbers of people in our state who are disabled, health limited and cannot work to afford insurance. And due to geography, large areas of the state have little choice- like SE MN, which largely has only BCBS and has some of the highest rates due to the market pressure enforced by Mayo on those communities.

                      “ACA caused a huge tax on the wealthy.”Unless you make most of your money passively by trust or hedge fund income, it amounts to 0.9% for most families. Even Warren Buffet only would realize a savings of 640,000 and I doubt you or I or many live at that level of income. Progressive taxation is the only way to not unfavorably burden the poor or middle class for costs of government.

                      “Government tried to create a product for people that wasn’t needed” The governmen stepped in because private insurance would not. And because insurance companies would not underwrite fair rates and policies, ACA was enacted to create a new market for the previously on insurable. This large pool of uninsured shifted costs to the insured with little penalty save the lack of insurance and the anxiety that caused. And it forced hospitals and providers to shoulder the cost and everyone via Medicare part A subsidies to facilities.

                    • Submitted by Paul Udstrand on 06/30/2017 - 08:24 am.

                      Thing is…

                      “As I said above… We do great on quality and availability / timeliness…”

                      Saying doesn’t make it so. The fact is that the US does NOT do “great” on any of those measures compared with other developed, and even many less developed countries. Our over-all quality is substandard, we have higher mortality, post surgical complication, and hospital infections rates for instance. The idea that we could have good metrics on availability and “timeliness” while having the highest rates of uninsured is simply fatuous, not to mention our pre-authorization requirements, physician shortages, or high co-pays and deductibles that discourage contact with medical professionals in the first place. I could go on but the metrics are available for anyone who wants to step away from stereotypes and actually look at the data.

                      Sure there are urban legends about Canadian and European horror stories, but for every one of those urban legends we can point to tens of thousands of REAL experiences in the US.

                    • Submitted by John Appelen on 06/30/2017 - 01:59 pm.

                      Feel free to go elsewhere for your care. Since I work with people around the world and have heard first hand, I’ll stay here with the Kings and Tycoons…

                  • Submitted by Karen Sandness on 06/29/2017 - 10:13 pm.

                    If I had a child with a serious medical condition

                    I would want to take him or her to a hospital where we would not be turned away for lack of insurance.

                    • Submitted by John Appelen on 06/30/2017 - 02:22 pm.

                      Really? You would put affordability ahead of quality and availability / timeliness when picking a hospital?

                      You are a very rare American. Most of us want the highest quality, the product/ service immediately and the lowest cost.

                      I guess I would take on personal debt to ensure my children were treated in a great hospital with very capable professionals if they had anything serious going on.

                    • Submitted by Paul Udstrand on 07/01/2017 - 08:04 am.

                      Seriously

                      I hope you never find yourself in a situation where you’re child requires treatment your insurance won’t pay for, or need to go outside you’re approved network. If such a thing were to happen you would be in for a very rude awakening and would likely face financial ruin whether you have insurance or not.

                      Healthcare isn’t a “product” like other products, the highest quality simply isn’t available for the “lowest” price. Any healthcare system that inflicts financial ruin on any patient in exchange for treatment is a fundamentally immoral system. Such systems are also rare, ours is one of the few, and economically damaging and unsustainable.

      • Submitted by Karen Sandness on 06/29/2017 - 10:16 pm.

        That idea of “unsuccessful citizens” sounds an awful lot like

        “useless eaters.”

        I’m reminded of the 1973 movie “Executive Action,” which mainly expounds a theory about the Kennedy assassination, but which contains a scene in which the conspirators (all good ole boys) sit around in an opulent parlor talking about the need to “cull the herd.”

        • Submitted by John Appelen on 06/30/2017 - 02:27 pm.

          Interesting

          I would rather pressure the herd to become more capable, personally responsible and self sufficient. I have faith that they can with the correct motivators and support, Why are you so certain that they can not?

          That they need continual handouts…

          • Submitted by Paul Udstrand on 07/01/2017 - 10:04 am.

            Even more interesting…

            What’s interesting is the idea that the function of Government in a democracy is to “herd” citizens. Again, your problem is that your notions of capability, responsibility, and self sufficiency are not universally accepted.

            I keep saying one of the primary characteristics of the reactionary conservative mindset is a rejection of democratic society on a basic level. For all their chatter about individual rights and responsibilities at the end of the day the Republican agenda isn’t about participating in the democratic process, it’s about capturing the levers of government and using them to force everyone into compliance.

            Health care isn’t a hand out by the way.

  8. Submitted by Tim Smith on 06/27/2017 - 01:41 pm.

    If you were to choose to go without coverage, and then try to get insurance after you got sick, the Senate version would allow insurers to refuse to cover you for up to six months. So your “freedom” to be uninsured bleeds right into the insurance company’s freedom to deny coverage to the already-sick.

    Wait, if i choose not to have insurance today(under ACA rules) and I get sick today, what happens? I have to wait until January first 2018 before I get covered. that’s 6 months away. Why is one approach mean and the ACA isn’t?

  9. Submitted by Tim Smith on 06/27/2017 - 03:33 pm.

    and

    Why would you buy health insurance if you could wait until sick to instantly enroll in it? Then drop it when well. Clearly the Obama administration understood that and included open and special enrollment provisions in the law. Not mean, just common sense, facts and reason.

  10. Submitted by Mike Chrun on 06/27/2017 - 04:54 pm.

    Peter and Paul

    The CBO’s figures projected $33 billion in tax cuts for the top 400 income households in the country in the House bill. It’s not going to be very different in the Senate version. It’s hard enough to wrap your head around those numbers, let alone to make the jump to the tired argument that somehow those poor folks will suffer because Peter is being robbed to pay Paul. The people who will suffer are the poor, children, and the aged. But Republicans can always hide their craven lack of empathy, unhindered greed, and outright nastiness under their piousness and concern for pro-life policies.

  11. Submitted by Tom Christensen on 06/27/2017 - 09:53 pm.

    It has to happen to them first

    Former GOP Representative David Jolly of Florida said he hated Obamacare before the last election. Then an event happened that changed his thinking. He lost his last election, was now without a job, he has a preexisting condition, and he would be without healthcare coverage, if it weren’t for Obamacare. He is not the first Republican to see the light when a Republican backed philosophy confronts their life and it changes their thought process. Dick Cheney was vehemently against gay marriage, then his daughter declared she is a gay. Suddenly Dick Cheney is quiet on the subject. It has to happen to them before they will change their minds.

    The American public was slow to realize the benefits of Obamacare but now more Americans than ever before like the program. It is not a hard decision when you compare what Obmacare offers and you see what Trumpcare takes away. The comparison proves you are not considered a priority by the Republican Party as they are only focused on the special few.

    Obamacare is fixable, Republicans not so much.

  12. Submitted by Ron Gotzman on 06/28/2017 - 07:23 am.

    No mandate….

    no mandate -means you can buy insurance that fits your needs rather than the top-down, special lnterest driven Obama prescribed plan. Also, I am glad you are in favor of a single payer plan- maybe you can encourage the MN Senators to run for election on your plan.

    • Submitted by Neal Rovick on 06/28/2017 - 09:19 am.

      Well, if you make a limited amount of money and are stretched even further by the higher premiums for Trumpcare (up to double the Obamacare rates) which cover even less of the costs (58 vs 70%), are you really ahead of the game when you get ill, have $100,000 in medical costs (blink of an eye) and end up owing $42,000.00

      In a time when the majority of people are unable to come up with $ 500 for an unexpected expense ?

      http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/

    • Submitted by Bill Willy on 06/28/2017 - 11:41 am.

      Insurance that fits your needs

      Although it’s just one of many fantasies pushed by insurance sellers and Republicans (“We can lower premium costs by letting people to choose the plan that fits their needs instead of forcing everyone to pay for a bloated list of conditions big government says have to be covered”) . . . the idea that anyone has the ability to select a plan that fits their needs is pure bull.

      That’s where those pre-ACA (good old days) things called “bogus” and “useless” policies used to come from: Buy that $49.95 per month “plan,” pay for it for a few years, get involved in an accident or get sick enough to need a hospital and guess what . . . That plan you picked because it fit your needs doesn’t cover most of what’s ailing you, if it covers any of it at all.

      And next thing you know, there you are, on the hook for an amount that makes you cry (for years, even after you’ve filed for bankruptcy).

      No one knows what they’re going to need because that would involve predicting the future.

      When are you planning on getting into that car accident?

      When do you think you might be getting a cancer, or MS, Lyme’s disease, Parkinsons, Ebola, Bad Bird flu or Mad Cow diagnosis?

      And did you remember to choose a plan that covers that damaged ear drum you picked up when your buddy lit, dropped and blew off that cherry bomb right next to where you were sitting next weekend?

      No? Forgot those things? They didn’t show up in your crystal ball when you were designing your Perfect Fit Plan?

      Oh well. Nuthin’ the insurance company can do about it because remember: It was YOU who picked out that plan that “fit your needs,” not them.

      I’ve always thought of those bargain basement policies as Psychic’s Specials.

      If you look a little deeper into your own idea you’ll see those plans are just one more way insurers transfer the cost of health care to consumers: They collect your premiums (like clockwork) and then, when you try to cash in on your “investment in your financial security,” they’re so sorry but they just can’t help you because your condition’s not covered by your plan.

      They understand, feel your pain and wish you really really well, but their hands are tied because you chose what you chose.

      “Good luck!” they say. “And by the way, don’t forget to keep paying your premiums or your policy will lapse and you’ll need to go to the back of the line and start over. Thanks for calling!”

      • Submitted by John Appelen on 06/29/2017 - 08:12 am.

        Good Points

        I actually like the mandatory base coverage and you must carry insurance aspects of ACA.

        I see it as no different than our society requiring drivers to carry minimum liability insurance.

        It is there to prevent others in society from having to pay for a persons poor choices. And since our society has decided that no one will be left untreated to die no matter how foolish they are, mandatory payment into the pool seems logical.

        Besides those onerous federal policies are very similar to what most good employers choose.

  13. Submitted by Paul Udstrand on 06/28/2017 - 10:37 am.

    Without Medicare for All….

    The lack of a mandate will just drive premiums and deductibles up and force people out of insurance. The only way to really “fix” Obamacare is to replace it with MFA. In essence, neoliberal market regulations are defunct, there’s simply no way to tweak Obamacare to the point where costs are reduced and everyone is covered.

  14. Submitted by Cameron Parkhurst on 06/28/2017 - 11:02 am.

    It comes down to empathy or a lack of empathy

    Kayla Chadwick, a Huffington Post contributor summed it up well.

    “I cannot have political debates with these people. Our disagreement is not merely political, but a fundamental divide on what it means to live in a society, how to be a good person, and why any of that matters.”

    http://www.huffingtonpost.com/entry/i-dont-know-how-to-explain-to-you-that-you-should_us_59519811e4b0f078efd98440?ncid=engmodushpmg00000003

    • Submitted by Paul Udstrand on 06/28/2017 - 02:56 pm.

      Yeah

      There’s no way to enter a conversation about empathy or compassion with a sociopath. The best they can do is mimic compassion, and these guys aren’t even interested in doing that.

      It’s weird that this has come so far. Here we have a bunch of Republican/Libertarians who literally believe that people who don’t share their values actually deserve to suffer and die, simply because they don’t meet Republican/Libertarian standards of humanity or citizenship. The fact that these sociopaths see themselves as champions of superior values is simply a toxic irony.

      Here’s the thing: We’ve seen their values, and we’re not impressed. In point of fact I’ll go out on a limb and suggest that these sociopaths don’t meet OUR standards of decency and social responsibility, and there are actually more of us than there are them. The difference is we don’t want THEM to suffer and die. We still want them, and their families to have health care, and housing, and security, and educations. And I wouldn’t change that no matter how toxic these people are. All we have to do is drag them and their “values” out into the light of day and see them for what they really are. We’re not going to change them, but we don’t have to, we just can’t let them change us.

    • Submitted by John Appelen on 06/29/2017 - 12:30 am.

      Excellent Questions

      Please explain what these mean to you?

      “what it means to live in a society, how to be a good person”

      How does it apply to:
      – behaving and performing in school
      – conforming to society’s laws
      – learning and working for one’s betterment and that of our society
      – maintaining one’s property and community
      – having and raising children with the participation of 2 responsible parents
      – earning, spending, saving and investing
      – addiction
      – staying dependent instead of changing, improving and becoming independent
      – buying products from American vs Foreign workers
      – allowing illegal workers to take jobs from legal members of society

      Now I am fine with progressive taxes as long as there are “good citizen” expectations for everyone. Thoughts?

      • Submitted by Paul Udstrand on 06/29/2017 - 09:16 am.

        John…

        You live in a free country. In a free country YOU don’t get to dictate what a “good” person or citizen is, and that’s a good thing because I for one am not impressed with your definition. Your “list” of “values” contains absolutely no mention of: Integrity, compassion, intellect, cooperation, generosity, or the simple suggestion that we care about one another and think about the consequences our actions have on others, future generations, and our environment. Your’s is a list devoid of any real values to my mind.

        You’re entitled to your values sir. However having seen your values I’m not impressed. Fortunately in a free country we can live according our own values, you don’t get to outlaw single parents and deny them health care, housing, or education, and I get to care about the welfare of single parents, whether they buy American or not.

        • Submitted by John Appelen on 06/29/2017 - 11:13 am.

          Apparently everyone gets to have an opinion regarding…

          “”I cannot have political debates with these people. Our disagreement is not merely political, but a fundamental divide on what it means to live in a society, how to be a good person, and why any of that matters.”

          I like you, also get to care for many people I do not know and do so through giving generously to charity and giving blood regularly. The difference is that I take action and give personally, rather than your insisting that the government take from the Peters to give to the Pauls. Thus enforcing your values on to the Peters.

          What I find hypocritical about the Liberal view is that they are adamant that they know what a good “successful” citizen should be saying and doing. (ie pay much more of the burden / cost of our society) And yet like yourself they have absolutely no expectations of what less successful people should be doing to be “good citizens”.

          • Submitted by Neal Rovick on 06/29/2017 - 02:48 pm.

            You don’t get it—your definition of what a “good citizen” is and what “successful” is are not the same as most of the people here. Your definitions seem to be mostly centered around money and money accumulation as the main measure of worth of a person.

            Further, the idea that your definitions of those terms is how you want to divide society into the “deserving” and “undeserving” columns is unpalatable to those same people.

            • Submitted by John Appelen on 06/30/2017 - 10:07 am.

              Definition

              What is your definition?

              Mine is centered around what is good for the USA (ie our society)

              – Makes good use of society’s investment in their education. (ie graduates HS and is proficient academically)

              – Obeys the laws of our country (ie drugs, immigration, other)

              – Gets financially stable before having children, only has the number of children they are capable of caring for themselves. (ie don’t require additional investment from society)

              – Both Parents are actively involved in the support and raising of the children. Ensure kids are fed, learn and mature to become good citizens.

              – Continues life long learning, works, volunteers, gives to charity, etc to help themselves and our country be all we can be.

              Do these seem unrealistic? Rationale?

          • Submitted by Paul Udstrand on 06/29/2017 - 03:03 pm.

            Peter’s and Paul’s

            Liberal’s aren’t the ones tying to assign relatively different value to human life, We don’t argue that one persons life is less valuable than another’s because they don’t buy American, or have a good job, or raise children the way we think they should raise children, or meet our standard of “success”. The suggestion that one persons life may be worth less than another’s for any of these reasons is morally repugnant to liberals.

            I’ve know people my whole life that meet your definition of “successful”, and some of them were awful human beings and detestable citizens, basically successful sociopaths. I’ve known people who fit your definition of failures who were outstanding human beings and exemplary citizens.Yeah, liberals can be as adamant about our values as anyone else, don’t expect us to apologize for that, but when other people fail our test as decent human beings and good citizens, we still want them to be well, and have health care, and security, and prosperity, even if we have to help pay for it.

            Being a citizen and paying taxes doesn’t make you victim of liberal oppression, it makes you a member of a community. No matter how “successful” you may be, outside of that community you got nothing. You didn’t build your own house, or your roads, your car, your TV set, or even your laptop. You didn’t lay the pipe that brings you water, or the wires that bring you electricity. You didn’t manufacture your furnace or produce the natural gas that heats your home. If you have a mortgage you bought your house with other peoples money. You didn’t grow or establish your business with money you printed up in your basement either. And whatever you’re business is, or you job may be, if you didn’t live a community full of people who buy your products or services, you’d be flat broke son. And we haven’t even started talking about the government services you rely on every day. You didn’t build the schools you went to or train the teachers that taught you. You think you “made” yourself? Whatever. You want to whine about taxes go ahead, but don’t pretend your “success” happened in a bubble of your own creation.

            • Submitted by John Appelen on 06/30/2017 - 10:13 am.

              Who Is We

              “even if we have to help pay for it. ”

              I am guessing that few of the commenters here are in tax brackets we are talking about.

              So what you are really saying is

              We still want them to be well, and have health care, and security, and prosperity, even if “the successful” have to help pay for it.

              • Submitted by Paul Udstrand on 06/30/2017 - 11:24 am.

                Yeah…

                “We still want them to be well, and have health care, and security, and prosperity, even if “the successful” have to help pay for it.”

                That’s exactly what I’m saying. Was I unclear about that?

                I don’t know what tax brackets your talking about but let’s remember that the wealthiest and most successful among us pay the least in the payroll taxes that finance SS, Medicare, and Medicaid. Payroll taxes are currently capped at what? $112k? So those making $200k are actually paying LESS for other people’s health care than those making $100k. For what it’s worth, I’m NOT in the $200k tax bracket, but you don’t see me whining about my taxes or paying for someone else’s health care.

                By the way, we understand that almost NONE of us actually pay for our own health care right? Very very very few people, primarily those who make $800k a year or more actually pay for 100% of their own medical bills out of pocket. Everyone else who has insurance pays a fraction of a fraction of their actual medical bills, no matter how successful they are.

                And for the record, the health care system I advocate (Medicare for All) would actually reduce costs, and lower premiums for 90% of Americans, and provide universal coverage, everyone would have health care.

                • Submitted by John Appelen on 06/30/2017 - 02:13 pm.

                  Just Making Sure

                  You said “we” are willing to pay for it, when in reality you are not paying for it.

                  And by the way, social security and medicare are good mostly self funding mandatory insurance programs that are funded by payroll taxes. Their biggest problem is that the rates should be raised to match the desired future benefits.

                  Medicare on the other hand is pure welfare that is funded through income and other taxes that are highly progressive. II am a fan of medicare and disability for the old and those who truly are unable to learn, work, improve, etc. Unfortunately folks on the left have little faith in the ability of many to do so.

                  • Submitted by Paul Udstrand on 06/30/2017 - 04:32 pm.

                    Ummmm?

                    As a tax payer and a privately insured person I most certainly am paying for other peoples health care, and I’m not complaining about it.

                    We’ve already established that payroll deductions pay for SS and medicare, and that the most successful among us pay less because their deductions are capped at something like $112. To repeat, someone making $200k is actually paying less in payroll taxes than someone making $100k. So the more “successful” are paying less than the less successful for other peoples health care. You seem to be trying to claim something else.

                    It looks like you are confused about the difference between Medicare (the Federal program) and Medicaid (Federally regulated State progams)? Medicaid is jointly funded by the Feds and States, and the Fed portion comes out of FICA payroll taxes. The state portions may come out of some other part of a States budget, but it’s still paid with tax revenue. In MN by the way “Medicaid” is actually two programs, MA – Medical Assistance, and Minnesota Care or MinnCare. In 2016 the Feds paid for around 65% of MN’s Medicaid costs. The rest came out of a provider tax enacted specifically to pay for the state’s program.

          • Submitted by Paul Udstrand on 06/30/2017 - 09:05 am.

            Hypocritical liberals

            John,

            I know people who fit your definition of “successful” people who are awful human beings and lousy citizens, I would say our current president is one of them, a successful sociopath. I also know people who fit your definition of failures who are outstanding human beings and fantastic citizens.

            The problem with a lot of reactionary conservatives is that they can’t distinguish between their economic principles and moral principles. This is nothing more than a celebration of wealth pretending to be a moral system, it’s a characteristic of class warfare going back centuries. Even Adam Smith warned that economic systems are devoid of inherent morality, note the slave trade that was thriving when “Wealth of Nations” was published.

            The very notion that anyone could assign more or less relative “value” to any human being based on metrics like whether or not they buy American, or raise children the way conservatives think children should be raised, or some degree of economic “success” or wealth, is morally repugnant.

            But here’s the thing, whether I think your a successful sociopath or not, (and obviously not ALL sociopaths are “successful”) I still want you to be well, and have health care, and shelter, and a happy family. I’ll never be impressed with your morality but I don’t place a lower value on your life.

            As for those who whine about their taxes I would simply point out that taxation doesn’t make anyone a victim of liberalism, it makes people citizens and members of their communities.

            • Submitted by John Appelen on 06/30/2017 - 04:15 pm.

              T2

              Medicaid and healthcare subsidies like the other welfare programs are paid for by income and other progressive taxes. And yes we need these for the truly disabled and short time hard up folks.

              Medicare and social security are mandatory insurance programs where the premium somewhat matches the benefits received. The payroll tax rate should be increased to keep them solvent, but otherwise they are good programs.

              • Submitted by Paul Udstrand on 07/01/2017 - 08:31 am.

                Clarification

                Medicaid is a federally regulated and subsidized program administered by States. The Feds currently pick up around 65% of Minnesota’s Medicaid expenses, and that money comes out of FICA payroll deduction. The States portion of Medicaid if financed by a tax of around 2% on health care providers revenue, it’s not drawn from progressive income taxes.

                Buy the way in Minnesota our “Medicaid” program isn’t actually called “Medicaid”, we have two programs, MA or Medical Assistance, and Minnesota Care, both of which cover around 14.5% of our insured population or 30% of our insured population when combined. In 2016 Minnesota spent $11.5 billion on it’s State subsidized health care programs, of which the Feds kicked in around $8 billion.

                The current Republican plans cut Medicaid subsidies by something like 30%, Obamacare had increased those subsidies. This would mean Minnesotan’s would have to come up with another $3-$4 billion in order to maintain current coverage. That will cost Minnesotan’s more because the financial pool is smaller, i.e. 6 million vs. 300 million.

  15. Submitted by Steven James Beto on 06/29/2017 - 05:29 am.

    Preferences?

    What does it reveal about Republican preferences? What it reveals about their character and moral fiber is more to the point.

    • Submitted by ian wade on 06/30/2017 - 08:22 pm.

      Considering the comments from Republicans

      I’d say that the key attribute to their character is an overwhelming desire for conformity to a rigid “moral” standard for which they have christened themselves as the final arbitrator. Their preference is authoritarian in nature and punitive to anyone that doesn’t fit their definition of what a productive member of society is.

      • Submitted by Paul Udstrand on 07/04/2017 - 10:00 am.

        Ian

        I wish I’d written that. Can I copy it and just paste in the future whenever this discussion arises? 🙂

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