Obamacare Creators told GOP: We told you so

http://www.msn.com/en-us/news/politics/obamacare-creators-tell-gop-we-told-you-so/ar-AAo4yv4?li=BBnb7Kz&ocid=U348DHP

President Donald Trump said last week that "nobody knew that health care could be so complicated."

But the aides and advisers who worked on health care for Bill Clinton and Barack Obama — they knew.

"Maybe I should just say karma is a serious thing," said Neera Tanden, who was a top health official in the Obama administration. "Health care is hard. Governing is hard. And Republicans are now living with the fruits of never putting forward a plan and making promises they can't keep."

It's a strange place to be for the Democratic operatives and elected officials who saw their party devastated in part by Obamacare. And some can't help but feel a bit of cosmic justice as they watch Republicans, who passed their plan Friday in the House Ways and Means Committee, stuck in a policy quagmire they know all too well.

Jonathan Gruber, an MIT economist who helped design the Affordable Care Act, said health care policy is both extremely complicated and extraordinarily personal.

"It's healthcare, it should be easy. Everyone goes to the doctor. But it's super hard," Gruber said. "As a result, it's easy to demonize everything."

He added, "They (Republicans) have spent years trying to demonize Obamacare and say there was something better, but there was nothing better ... It's overall a sad story. I don't think anybody can feel good about this."

Clinton strategist James Carville, a veteran of both recent Democratic reform efforts, has a maxim that "the mover on health care loses," as he told Democratic donors at a January retreat in Florida. "To do something is to lose."

After years of unpopularity, nearly six-in-10 Americans now say they want to keep Obamacare or make only minor fixes to it. Fewer than four-in-10 call for repealing it or replacing, according to a new Monmouth Poll.

Republicans "now own the American health care system, which is something that they very effectively said that we owned for seven years," said Ben Wakana, a former spokesperson for Obama's Department of Health and Human Services.

"As you see this circular firing squad, part of the problem is they don't have any principles on health care," he added. "The thing that kept us grounded when things got hard was we had principles. That kept us all on the same team and in the same room."

"If you look at the big debates about health care starting with Truman, going to Nixon, going to Clinton, going to now, you find that on the surface, the issues look really straightforward because everybody agrees health care is a big mess. But then you peel it open and it's unbelievably complex," said Robert Blendon, a Harvard professor who studies the politics of health care. "It starts to break apart the minute you get into the details."

That's exactly what happened after House Republicans rolled out their draft bill to repeal and replace Obamacare Monday night. The response swift and largely negative, leaving a plan seven-years-in-the-making in critical condition less than 24 hours after its public debut.

"The Republicans have done what Democrats couldn't: Brought the popularity of Obamacare to record levels. They made every election a referendum on Obamacare," said former Rep. Steve Israel, a Democrat.

Israel led House Democrats' election efforts during the brutal 2010 midterm, when Republicans rode an anti-Obama backlash to gain 63 seats. Now Israel anticipates Democrats will run on, instead of away from, health care.

"You can expect House Democrats to make the midterm election on 'Ryancare," he said.

Democrats have already started collecting sympathetic stories from people who credit the ACA with saving their lives.

And the party's campaign arms are zeroing in on a handful of provisions in the proposed draft they think are politically toxic: Funding cuts to efforts to fight the opioid epidemic, penalties for Planned Parenthood, and a tax break for insurance company CEOs who make more than $500,000 a year.

The 2018 midterm elections are still a ways off, but Democrats say they intend to put repeal front and center.

"GOP Senate candidates will now have to defend an agenda that protects the wealthy and well-connected at the expense of Americans who actually work for a living," said Maryland Sen. Chris Van Hollen, who chairs the Democratic Senatorial Campaign Committee. "Regardless of whether it gets a vote, we'll make sure there is no rock Republican Senate candidates can hide under."

White House spokesman Sean Spicer holds a press briefing at the White House in Washington Jan. 23, 2017.House Chair to Spicer: Mind your business

There were plenty of warnings about Obamacaid too... which proved true.... and disproved the lies.

There's nothing written in stone yet however with this legislative process.

I don't like much of what I've heard so far... mostly because it isn't real change.

If one has really read this bill then you'll see the idiot's are leaving million's or billion's on the table as they rolled back the mandate and most taxes associated with obamacare to Dec 31, 2015. How stupid is that?

The mandate
The tax that insurer's pay to the fed's for each policyholder they have
Medical Device
I believe tanning beds and etc.

People who paid the penalty for 2015 and the ones who already filed their taxes for 2016 and paid penalty will have to do amendment's to receive a refund.

Should change the expiration dates to 12/31/2017.

I think I saw in one thread pkr that you said the penalty shifted from the feds to insurance company's? You are correct and you just cannot sign up anytime, still open enrollment. The penalty 30% if you haven't had continuous coverage will end up as much or more than the penalty now imposed.

Take the 50 million or so between 50 and 65 and let them buy into Medicare at around $350-$400 per month, some will be healthy, could save the Medicare program down the road. Take everyone under, lower rates and go back to the old way of medical underwriting, but insure everyone, the ones with a medical condition put a 12 month waiting period on that condition and cover everything else. Try a risk pool again for the poor and chronic conditions like cancer, etc.

Tax credits are nothing but a subsidy, how stupid do they think the American people are?

Then I see where this is just the first phase? WTH 2 more phases to come, that aren't even written yet?

I printed out the transcript of Trump's meeting with health insurance CEO's a couple week's ago, amounted to 1 page and about 35 minutes. Trump talked about himself most of it and then ask everyone to introduce themselves. That was it, there is no collaboration between company's and the swamp.

Feds should not be in the health insurance biz unless they want to change everyone to Medicare.

The fifty year old entry into the Medicare program with a small monthly premium is gold. It will lower the rates for younger people, and it will give older workers piece of mind. Taking away the taxes to support these programs is disgusting. In the end it is just one more opportunity to make the rich richer.

Obamacaid was like a knife shoved into your chest. It's probably going to kill you to pull it out instantly.

But your probably going to die no matter what. Obamacaid was designed to fail. There's no viable fix.

The only solution I see is to create a separate govt system. Then let's see a real comparison.

http://www.huffingtonpost.com/entry/insurance-companies-medicare-for-all_us_58c1b1fae4b054a0ea690dc8?on2f1z08oxi7wrk9&

America’s Health Insurance Plans, the trade group for commercial health insurance companies, published an infographic this month breaking down how the industry spends every dollar it receives in premiums.

The group apparently crafted the visual aid to defend rising premiums its member companies are charging customers.

But the chart also inadvertently helps explain why commercial health insurance is a bad deal.

The graphic shows that about 80 percent of every premium dollar goes toward medical expenses ― prescription drugs, doctor visits, hospitalization and other services. Approximately 18 percent goes to administrative costs, and some 3 percent is profit. (The total is more than 100 percent because of rounding. America’s Health Insurance Plans explains how it gathered the figures for its infographic here.)


AHIP
America’s Health Insurance Plans created a graphic to show where your premium dollars go.
By contrast, Medicare, the largest U.S. public insurer, paid just 1.5 percent of its budget to administer traditional insurance plans for seniors and workers with severe disabilities in 2015, according to official data. The rest of Medicare’s budget went to paying doctors, hospitals, drug companies and other health care providers.

When you account for administrative costs of Medicare’s private plans, which cover some one-third of Medicare beneficiaries, Medicare’s overhead approaches 6.4 percent of its budget.

The comparison shows that expanding Medicare to cover the entire population ― or adopting a single-payer health insurance system ― would significantly reduce health care costs by eliminating a whole lot of expenses that aren’t related to medical care. That’s in part because Medicare does not have to advertise its services, make a profit for investors, or reward its executives with multi-million-dollar compensation packages, as private insurers do.

If the Republican health care replacement law takes effect, it could encourage companies to jack up executive pay even higher. The legislation would raise limits on how much executive compensation a company can deduct from taxes.

Some critics claim the Medicare figures are misleading, because the government insurance program benefits from Social Security Administration and Internal Revenue Service help in collecting the taxes it needs to fund its operations.

In fact, Medicare reimburses the other federal agencies for their services, according to Paul Van de Water, a senior fellow at the liberal Center on Budget & Policy Priorities.

“The notion that there are all these federal costs that are not accounted for is absolutely positively false,” Van de Water said.

There are risks and tradeoffs of a single-payer system, like the possibility that insurance coverage will provide fewer benefits than the private insurance market, according to Austin Frakt, a health economist for the Department of Veterans Affairs with academic posts at Boston University and Harvard.

And there are other systems for bringing down costs, like all-payer rate setting, which allows multiple insurers to negotiate provider prices as a single unit, Frakt added.

But “if you look just at cost control, you almost can’t do better than single payer,” Frakt said.

Thanks, America’s Health Insurance Plans!

Compare something where the govt competes against a private market... such as mailing a package.

It's really flat ridiculous to hold up any govt system as the standard of efficiency or economy.

It's really flat ridiculous to hold up any govt system as the standard of efficiency or economy.


It sure sounds like 1.5% is more effcient than 3%.

Imagine if trumpcare were handled exactly as Obamacaid was... lol.