Monday, July 3, 2017

Would you buy a used car from Donald Trump? Repeal without replacement, a terrible deal.for the GOP

Trump's  newest deal he does not want you to refuse is to have Congress vote for repeal of Obamacare with a promise to give Congress a year to come to a solution.   This idea is a trust buster. He reversed himself from a prior promise to do both simultaneously. The plan he endorsed resulted in 22 million uninsured, hardly his pledge to replace Obamacare with something better. The GOP has not come up with a replacement in 7 years and 6 months  of trying and this  repeal without replace is  a gift to Democrats.  First, a year for now is the mid terms and it would be the best ammo Democrats could have to defeat vulnerable GOP House candidates. (All House members are up for re-election in 2018).

Delaying the replacement for a year would destroy Obamacare at once  since this guarantees no insurer would participate in the exchanges because insurers have to set prices based upon risk a year in advance and it is even  a program may not even exist after 2018. Either they would pull out or they would raise premium  rates so high, it would make Obamacare financially unsustainable or affordable.   Not coming up with a replacement  during this coming 12 months in a year would mean an end of  insurance   for 32 million who have benefited by the affordability of health insurance Obamacare provided, not just the 22 million who their proposed legislation would leave without insurance in the next ten years.

What the GOP is weighing is that by a repeal without replacement vote now  is  it would protect their core who swore to vote for repeal and protect them from attacks  in their primaries from their right who would consider anything resembling Obamacare too far to the left because it continued the outline of a federal program. Only 30% of the GOP wants repeal without replacement, per a USA today poll.

What it would  also do is give opposition to GOP plans to cut Medicaid and exchange subsidies to grow even more to the current type of House and Senate versions that are polling between support of 10 to 30% and even are upside down among  their own GOP affiliated  voters. Do they really think opposition will cool in the middle of an election year? If the GOP thinks that the sabotage of  Obamacare will be blamed on the Democrats because they think it would  be  a  successful strategy be  to force Democrats to the table out of desperation, the fact is the public is not so stupid. They know that the GOP can fix it if they want and have the power to do so since they control both houses of Congress and the White House. Moderate Democrats have always expressed desire to work with the GOP on a repair fix without a need to sabotage Obamacare as a motivation to get them to the table.  The China Shop rule: The GOP broke it; they own it.

Sunday, July 2, 2017

Trump's commission's wild goose chase to find 3 million illegals voting in 2016 is dangerous

The attempt by this commission to justify an off the cuff tweet by Trump that he lost the popular vote because 3 million illegals voted is not only a wild goose chase, it is dangerous. One of the real protections against Russian interference in our elections by misusing voter registration lists is the fragmentation of that data each of the 50 states maintain. It is harder to hack 50 than one so now this commission wants control over all in one federal data bank? And give the Trump administration the ultimate control over 50 states voter lists? Williams is right: just give them something that is already public information, but not the vital statistics a power could use to control an elections. whether that power is domestic or foreign. Those public registration lists are available to anyone, but they do not contain the personal data the Commission requested that Williams is refusing to supply.

What is astounding is that the public as a whole is not outraged nor do they seem concerned that the Russians have the ability to manipulate which candidate for President or even Senate could win a US political race. That is an attack on democracy and only a few seem to see the danger or even care. What is also puzzling is that those who ardently support states' rights, the GOP, are the ones least concerned.

Protecting the integrity of the registration data base is a sacred duty of local and state elections officials.
(Felicia Muftic is a former Denver, Colorado, Election Commissioner.)

Saturday, July 1, 2017

What Democrats need to do to win the House in 2018: first, avoid a civil war

Scheduled for Sky Hi News July 17-19
Regardless of how the repeal/replace Obamacare Congressional action plays out, the Democrats will have to be on the same page and not divided by an ideological split of whether to go for their hearts desire of Medicare for All or to repair the damage done by the Trump administration to anything resembling Obamacare.   Democrats have an opportunity to take more House seats in 2018 by running against the on the record of Republicans who voted  to take 23 million off the insured ranks. To have a civil war within the  Democratic party in 2018 and 2020 between the partisans for Medicare and fixes to Obamacare  means both Medicare for All or fixing Obamacare  would be the road to failure for both.

The Sanders and Clinton wings must  make peace and unite on  a short term goal. If they fail to do this, Democrats will remain powerless to influence any repairs to the health care system.  It is a dilemma that could be reconciled by seeing fixes to Obamacare as a short term goal while not giving up on Medicare for All down the line. The Democratic Party ‘s unified , winning goal should be best for consumers and achievable in the short term, not what is best for the ideologues. Most consumers are not ideologues; they just want good health care coverage  they can afford.

I personally support Medicare for All as the long term solution to covering as many people as possible with comprehensive health insurance. It also makes the most sense extending affordable comprehensive health insurance to the most people at the lowest cost, if experience in other countries indicate. It is a proven, popular method easy for the public to understand. I am on Medicare and I wish those under 65 could be, too. I have a choice of a private physician and while Medicare covers 80% of certain costs, I also pay about $45 more a month for a supplemental.  It works well.

I also realize that patching Obamacare type insurance would delay increasing public support of Medicare for All, but to let Obamacare type insurance fail  as a strategy to bring us closer to the time of Medicare for All  could gain enough  public support would cause much suffering in the transition time.  Putting  consumers close to desperation by opposing fixes  in order  to expedite  bi-partisan public acceptance of Medicare for All is doing harm to the very persons about whom liberals  profess to care.  It is not a way to make friends and influence voters in 2018 or 2020.

What about a Democratic Party alternative plan? Fixes to Obamacare type of insurance such as providing more subsidies for insurers  and stabilizing  the market to   cover rural areas would address a major failure of Obamacare. To lower premiums and out of pocket expenses without destroying the benefit package of essentials would address other major concerns of consumers who want lower lower premiums and less out of pocket costs.  Requiring drug companies to compete for the right to be providers could lower prescription costs.   To stop  undermining  the financing system needed to make private insurance affordable  on the exchanges or through Medicaid  is another. This means reducing or eliminating the tax relief to the rich as the original GOP plans  provided. These  proposals could make  a platform that would have appeal to all but the hard core libertarians and Trump loyalists.

Wednesday, June 28, 2017

Choice is a bogus issue in the Senate Trumpcare debate

I just listened to a panel of physicians, on TV, mostly big city specialists, who have the opinion that Trumpcare is better for patients for one reason: choice. I am a widow of a physician. Give me a break. 22 million people will not have health insurance and have no choice of a physician they can afford and will rely on charity care and the ER. Since our family was well heeled by a high earning family head, how easily is it to imagine how a family living of 26K a year affords health care. Even those of us with insurance in the private sector before Obamacare, I had no choice since I was in an HMO and had to stay within the network. In fact, now on Medicare, I have a supplemental that is also an HMO. Even PPO's have preferred physicians. Two of my  over 50 years old children have health insurance provided by an employer and their choices of plans are limited to 3 options picked by their human resources department. Every time they change jobs, their past employer plans are not offered and they sometimes cannot keep the doctors they had or the hospital they preferred. 

None of that would change if the Senate Trumpcare version were passed except that employers would no longer be required to offer employer insurance and there is no guarantee that consumers would not have to pay more to cover pre-existing conditions.  All three have pre-existing conditions and one does not have employer insurance, is over 50, and
is facing being forced out of the insurance market if the Senate version is passed allowing increased premiums for pre-existing conditions and  charging him as much as 5 times more than the younger ones covered. His choice would be not to have insurance because he cannot afford it, not because that is what he would like..
When asked about whether the Trumpcare Senate version would benefit the poor, no hand was raised. However, one physician suggested that the states or townships could pay for it and join together. Denver Health has been an enterprise fund and covers much of the poor without relying of local taxes. The reason, they rely heavily on Medicaid reimbursement and other patient insurance coverage to be self sufficient. Their operating loss due to Medicaid reductions would result in more local taxation. If the states themselves made up the differences in the loss, they too would have to raise taxes because most states are subject to balance budget requirements. A dollar of federal taxes comes just as much out of a taxpayers' income as do local and state taxes. There is a reason there is a bi-partisan group of governors opposing the Senate Trumpcare bills has become public.

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