[nathanbedford]

Right on, Diogenes.

[Lazamataz]

Was that a shot?

I thought we got along.

[Lazamataz]

To the substance: Freeper LS, who is one degree of seperation from the Trump inner circle, states:

1) No “clean” repeal was going to pass. Period.

2) The only hope is to take “some” bill and begin chipping away. Yes, you will have to fix the fix. That’s political life in 2017. Anyone who thought there would be a single swipe of the pen and O-Care would be gone was not thinking.

3) Trump has already tweeted that he “hopes” Rand Paul will come up with a great alternative to Obamacare (not, not to the “House bill” so as not to alienate them). Translation: if Paul and some other Senate conservatives (doubtful) can get a significantly better bill, this might be improved in reconciliation/conference.

4) The Senate is pretty much worse than the House on this, so it’s dubious whether this could happen.

5) There are a dozen “mini-fixes” that will significantly improve even this bill.

It's not all we wanted, but if LS is accurate, it's better than two empty hands.... and who knows what can happen after that.

[Jim Noble]

Look, let’s make it simple.

Obamacare can’t be repealed because the pro-repeal forces don’t have the votes. And if 51 votes in the Senate would do the job, they STILL don’t have the votes.

The two most popular parts of PPACA - pre-existing condition coverage and coverage as a child to age 26 - are untouchable. Expanded Medicaid (without tax increases) is almost as popular. Once you concede you will sell someone fire insurance after their house burns down, you will need a funding mechanism.

So, if the House Republicans have 218 votes for “clean repeal” (I doubt they do), but they keep pre-existing conditions and 25-year old children (because they must) then the economic death spiral leading to nationalization will worsen. But even at that, I doubt there are 30 votes in the Senate for a clean repeal.

To move forward, someone who is profiting from the status quo has to get it in the neck - and I think, after the political process plays out, the Ryan bill fails and Trump’s popularity falls as a result, it is the insurance companies that will be walking the plank.

Medical and hospital care paid for by other people’s money, however collected and however paid out, is fundamentally a political issue. As long as the government takes from you and gives to me to pay my bills, you will want a say in how the money is spent.

Medicare and Medicaid both, in different ways, promised to pay without limit for all medical and hospital services for people covered by them that could reasonably be expected to produce a benefit. Paying without limit with other people’s money is a nice idea, but, as we see, in practice it is unsustainable.

One way or another (presuming our form of government survives), the state must be able to produce a budget for what it will spend on health services. Under the assumptions that govern Medicare, Medicaid, Obamacare, the refugee programs, and others, this is impossible.

Something has to give. I agree with (and pray daily for the survival of) some free market aspects in health care, but the only way this is going to happen is with a national single payer universal basic coverage scheme with a private option.

Obamacare will not survive. Romney-Ryan care can’t pass. Full-on user pays will close most hospitals and practices within a few months.

I believe Trump will propose a single-payer scheme after Ryancare collapses. I hope he sees the wisdom of a private option. But, one way or another, single-payer will be a reality.