A detailed look at the new Republican Obamacare revision


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Link here [pdf]. This is worth a read, as it provides the best most detailed look at the Senate’s proposed bill I have seen so far.

While the bill has many good things, overall it really is no different than Obamacare. It is a bureaucratic mess, it leaves many of Obamacare’s worst rules in place (such as the requirement that everyone, male or female, pay for maternity care), and it continues the inappropriate micromanaging of Congress in this private sector industry.

It might pass, but if it does, all it will accomplish is to stain the Republicans with this monstrosity of a law, as premiums will surely continue to rise, as will medical costs. Up until now, the Republican Party has been saying it had nothing to do with Obamacare and its consequences, and for one rare time, these politicians were not lying when they said that. If this bill becomes law, however, they will no longer be able to deny their part in Obamacare, unless they lie. And the public will know they are lying when they do.

Update: Heritage Foundation releases its own analysis which says this bill will encourage the growth of government.

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23 comments

  • SCooper

    I disagree with those who complain about men having to pay for maternity care. It is not like men are involved in the process. A court would have no issue with forcing the man to at least pay half for the pregnancy, why should the insurance company be any different. I want the insurance companies to stop cherry-picking and treat all the same. Soon they will require genetic scans to see what conditions you are prone to. It could even affect employment.

  • Rand Paul says he won’t vote for it. McCain just came out with a statement saying he will vote it down. That will probably influence some others who are on the fence.

    I’m guessing this thing is dead. Maybe that will finally force some real serious legislative efforts.

  • D. Messier: Heh. I strongly suspect that what you define as “real serious legislative efforts” will differ considerably from mine. You probably want some form of increased involvement by the government. What I want is a simple repeal bill as passed previously by Congress and vetoed by Obama. I am not afraid of the free market and capitalism. If we simply let it function without government interference, costs would go down and insurance would become affordable again.

  • Cotour

    But what about all of the people who will lose their healthcare? The mothers, the children?

    “Healthcare is a right!”

    I think that is how it goes.

  • wayne

    “Cornhusker Kickback.”
    Nebraska still has a permanent exemption from paying for their Medicaid expansion.

  • D. Messier

    R. Zimmerman: Trump really doesn’t seem to know what’s in the bill. And he doesn’t care as long as he has a bill to sign that reverses what Obama did. Republicans in Congress want a bill to justify what they’ve been promising to do for the past 7 years. A very bad way to try to pass legislation.

    Free markets prioritize profits. There’s nothing wrong with that for the vast majority of things. With health care, the need for profits often clashes with providing coverage for people. The focus is not necessarily on lowering premium prices for consumers, but maximizing profits for shareholders. We don’t have a system that focuses on providing health care for all. It’s for those who can afford it. Not sure how that helps promote the general welfare of the country.

  • wayne

    D. Messier:

    I would put forth the proposition, you fundamentally misunderstand freedom, liberty, and free-market economic systems.
    The problem isn’t with capitalism, its with Crony Progressive Statists of all flavors and variants, constantly stealing from the people for their psychopathic fantasies and lust for power & control.

  • Cotour

    “Not sure how that helps promote the general welfare of the country.”

    Would the “GENERAL” welfare of the country include that everyone own a house? A Martin “Jetpack”? https://youtu.be/rvmuDQjxKxg Now that’s one sweet ride, it would promote my personal general welfare (sans taking a header in it.)

    What would promoting the general welfare of the country not include? That might be the more correct way to view the problem and what promoting the general welfare actually means.

    Is healthcare a service? Or is healthcare a right? Healthcare is good to have and good healthcare is good, but do I have to pay for my own and someone else’s to, plus all the other services that I am paying for to boot to make healthcare a proper part of “The General Welfare”? (Accent on welfare)

    Wiki: “The United States Constitution contains two references to “the General Welfare”, one occurring in the Preamble and the other in the Taxing and Spending Clause. The U.S. Supreme Court has held the mention of the clause in the Preamble to the U.S. Constitution “has never been regarded as the source of any substantive power conferred on the Government of the United States or on any of its Departments.”[3][4]

    The Supreme Court held the understanding of the General Welfare Clause contained in the Taxing and Spending Clause adheres to the construction given it by Associate Justice Joseph Story in his 1833 Commentaries on the Constitution of the United States.[5][6] Justice Story concluded that the General Welfare Clause is not a grant of general legislative power,[5][7] but a qualification on the taxing power[5][8][9] which includes within it a federal power to spend federal revenues on matters of general interest to the federal government.[5][10][11] The Court described Justice Story’s view as the “Hamiltonian position”,[5] as Alexander Hamilton had elaborated his view of the taxing and spending powers in his 1791 Report on Manufactures. Story, however, attributes the position’s initial appearance to Thomas Jefferson, in his Opinion on the Bank of the United States.[12]

    These clauses in the U.S. Constitution are an atypical use of a general welfare clause, and are not considered grants of a general legislative power to the federal government.[13]”

    The solutions to this problem should not deprive me of my wealth or my freedom to spend it in the manner that I see best. And it should not enrich someone else at my expense. Somehow some way we must all have reasonable access to at least good healthcare and the best solutions lie in a free market approach. What has been going on has been the government wanting and needing to control the population, and there is no greater control over the individual than when a government can say when, where and who can have healthcare and how much of it they can have.

    Do not take my right to choose away. Now that is an actual right that is basic to my survival, my general welfare and my freedom. Just give me a choice and get rid of that damn Socialistic mandate in Obamacare!

  • wayne

    Cotour–
    Good stuff!

  • wayne

    “Mark Levin: What is the endgame of Statism?”
    03-24-2015
    https://youtu.be/nl_Qd_LncEI
    (13:16)

  • Edward

    D. Messier wrote: “Free markets prioritize profits.

    wayne wrote: “D. Messier: I would put forth the proposition, you fundamentally misunderstand freedom, liberty, and free-market economic systems.

    I agree with wayne. In a free market system, profits are the results of efficiently satisfying the customer. An unsatisfied customer is free to go to — or start — the competition. Each company has incentive to increase efficiency while still satisfying the customer. The launch rocket industry has recently become much more free market than when governments had control over it, and now we have SpaceX demonstrating just how efficiency, satisfied customers, and profit go together.

    It is in the captive market system, as we now have in US health insurance, in which profits can be made without satisfying the customer, because the customer must buy the product whether or not it satisfies his needs and desires. We still see some of this in the launch rocket industry, where most or all countries with launch capability require that their government payloads launch on their own country’s rockets.

    wayne wrote: “Cotour– Good stuff!

    Too bad I am not reading Cotour’s comments. It sounds like I am missing one of his occasional pearls.

  • Cotour

    Looking to get back in my good graces, Edward? Review this video once again and OBJECTIVELY assess what this material more than likely reasonably is.

    https://youtu.be/sxXdI4hLWkE

    Aluminum? Highly unlikely, it has the incorrect spectral signature and in the long shot view the material maintains its hot red spectral characteristics, aluminum pours silver to a slight / light to dark cherry and being shortly exposed to the atmosphere it goes fast to silver. This material is cherry red most all the way down to the ground.

    Rating this material from a 0 (meaning no reasonable assessment or even a reasonable guess can be arrived at)

    to a

    10 (100 percent certainty of what this material is) where do you OBJECTIVELY classify this material given its visual and physical characteristics? You or anyone else.

    At the 0 level this material is “Molten carpet’ at the 10 level this is approximately 3000 degree iron / steel.

    Put your objective high IQ / nerd scientist goggles on and tell me your opinion. Anyone can comment here if they like.

  • Cotour: This is off topic. I will not have you hijack another thread with this junk. If you post about this again in an inappropriate thread I will delete it, unread.

  • Cotour

    I apologize for miss applying this subject to an Obamacare thread, I really was only focused on Edward being out of sorts with me and this particular subject is where we both lost respect for each other. Me for his “Molten carpet” evaluation and he because I had not read every word of his response.

    Why not start an appropriate thread for the subject where all would be willing to participate objectively without any hesitation or preconceived notions? The analysis of elements of any recorded event that is surrounded in controversy is certainly not “junk”.

  • Cotour: No. BtB is not about conspiracy theories. You have failed to convince me (as well as everyone else here) of your position. I will not have my website focused on this.

    This conversation will now stop.

  • Cotour

    As you wish.

  • D. Messier

    > I would put forth the proposition, you fundamentally misunderstand freedom, liberty, and free-market economic systems.

    Thanks Wayne. My point is that you can’t run a health care system that covers everyone with a strictly free market approach.

    > The problem isn’t with capitalism, its with Crony Progressive Statists of all flavors and variants, constantly stealing from the people for their psychopathic fantasies and lust for power & control.

    Ah. I would suggest you fundamentally misunderstand the issues relating to this issue if that’s what you think.

  • wayne

    D. Messier-
    If the jack-boot fits….

    You sound like a Statist.

    For what rational reason, would we socialize the private health-insurance agreements for 180 million families, comprising 320 million citizens, just to take care of the less-than 10 million people requiring assistance?
    It certainly isn’t about providing insurance, now is it?

    “Idea’s so Wonderful, that have to be imposed onto the People against their will.”
    Buy their insurance or face criminal sanction from the IRS.
    (I seem to recall, we fought a Revolution over such crap-o-la.)

    Statism has systematically destroyed our private Civic Institution’s over the past 100 years, and which heretofore attended to those in need, in favor of a top-down, authoritarian, massive wealth distribution scheme.

    Anyone or anything, that advocates more Statism, is an enemy of Liberty. They are fundamentally incompatible.

  • Mitch S

    Let’s pretend we are congressmen who will have to run for re-election.
    Some constituents are clamoring for “repeal and replace”, some say “fix Obamacare by eliminating it so we can go back to the “good ol'” system”.

    But we know that Obamacare happened after 20 years of complaints and debate about our “overpriced, broken health care system”, so are we suddenly going to close the website, remove all the minimum coverage requirements, shutoff the spigot of money paying for people with pre-existing conditions and toss people back into dealing with the potpourri of of insurance providers and complex plans?
    We’ll be fried at the polls.

    “Let the free market handle it”
    There are some things to bear in mind when comparing healthcare to buying a car or shopping for a rocket to launch your satellite.
    When someone has a medical emergency they aren’t in a position to shop for the best deal on an ambulance, choose the most economical hospital and doctors etc.
    And healthcare decisions are complex.
    So there has to be some kind of framework be it laws, regulation etc.

    Frankly it’s too complex and too tough (any sustainable system means someone gets their goodies taken away) to do in one step (it also takes time for free markets to form and stabilize), so I recommend a step by step approach.
    If we force Republicans to fall on their swords repealing Obamacare, in a few years we may be looking at a form of Bernicare.
    In fact it may be the only politically possible way to improve the healthcare payment system is to go through a socialized phase (though it would have to be coupled with Fed borrowing limits – good luck!) so people could experience the compromises that come with such a system. (sure you’re fully covered – the doctor can see you in six weeks…).

  • wayne

    It took a100 years of progressive statism to get to this point with “healthcare.”

    The “market” was increasingly regulated & distorted every step of the way, incrementally.

    First they controlled “drugs,” then Licensing, then they systematically undertook to destroy our Civic and Religious Institutions (which historically took care of the “poor,”)then they imposed “social-insurance” (FDR) then they imposed socialized medicine for older people with Medicare (LBJ). Costs began spiraling out of control. Medicaid is then imposed for “poor people,” (and now 400% of poverty-level makes you “poor.”)
    Then they imposed Medicare Part D, a totally unfunded entitlement for baby-boomers to get subsidized drugs.
    Jeeze– we even spend $4 billion/year for free cell-phones, for 30 million people. (I have a pre-paid tracfone, who’s paying for my darn cell-phone? Me.)

    Now, everyone wants a free-ride, and they want the other guy to pay for it. And our worthless Crony Leaders…all they can think of is keeping their phony-baloney jobs, forever, and making us all pay for their extravagant lifestyle, under the lies of doing what is best for the Collective.

    It’s unsustainable, and a “System that Cannot Continue, Won’t.” (In an alternative Universe, this ends with the people dragging these statist’s from their castles, and shooting them in the face. Then it gets super-weird after that happens…)

    (I don’t recall people dying in the streets for lack of access to medical care, any time in the last 50 years.)

    Why don’t we try some Crazy Idea like free-markets and Federalism?

    Why do 180 million American families’, have to adopt socialism, so (less than) 10 million people can get free health-insurance??

    ‘Cuz it’s never been about healthcare or health insurance, it’s all about destroying our way of life, by any means necessary.

  • Cotour

    Healthcare has been successfully cast as being a right, having a phone has also been cast as a right, soon high speed internet will be cast as a right, a guaranteed basic income will soon be cast as a right. Pretty soon, no one will know what the hell a right actually is any more. These are not rights.

    All Leftist strategy to lull the masses into compliant and politically useful tools in the pursuit of utopia, and in utopia there is no such thing as the American Constitution. Why? Because it was written by a bunch of rich, white slave owners. And this entire Leftist / Democrat atmosphere of the last 30 years and more importantly the last 8 are all focused on accomplishing just that.

  • Edward

    D. Messier wrote: “My point is that you can’t run a health care system that covers everyone with a strictly free market approach.

    Really? The free market approach works for all kinds of things, especially necessities, yet there are no mandates that we buy anything except health insurance — which isn’t even the healthcare that is the actual need. The need is for healthcare, the insurance is just a convenience. The mandate is for the insurance, not the needed healthcare (when it is needed, we still have a choice whether or not to seek healthcare). Food, clothing, transportation, etc work just fine under the free market system. For those who are too poor for housing, there is government assistance, a coverage without a mandate that everyone purchase, lease, or rent housing, although there used to be charities for this.

    Mucking up (or another “f” word) everyone’s health insurance* just to cover a few people is a piss poor way to go. It is, in fact, counter productive. Everyone loses their liberty (literally, that is what a mandate does) yet is no closer to getting healthcare than we were before. All we have is a piece of paper that says we have insurance, but this does not guarantee that we will receive non-life threatening treatments in a timely manner, and there is evidence that it has reduced the availability of these treatments.

    Free markets find ways to cover even the poor, when charitable organizations are freely allowed to exist. The rest of us need not suffer, and our charitable donations go where we want them, not to taxes that then redistribute our wealth and prosperity to those who will vote for the corrupted political party over the free market party.

    Mitch S wrote: “So there has to be some kind of framework be it laws, regulation etc.

    That is what we had before Obamacare. It worked much better for less cost and without costing us our liberty and putting us into a tyranny. No one was denied healthcare when their lives depended upon it, and the states made sure that hospitals were compensated for those who could not afford it, thus even the poor were covered. People received healthcare, hospitals and doctors stayed in business, and insurance companies rarely abandoned state markets, and when they did, there were other insurance companies to fill the void. Now there aren’t.

    It didn’t used to be complex, but Obamacare made it so. They mucked it up in one step, and we pay them to be smart enough to unmuck it in one step. We elected them to do so, too. That is their job. Rather than falling on their swords, they will be soundly cheered for doing what they were hired to do. The only people who would complain are those who would never vote for them anyway, and it was the Democrats pandering to those people that resulted in the mess we are in now.

    Mitch’s logic is exactly what prevents us from regaining our liberty from the people we hired to retrieve it for us. Indeed, the Constitution, that these people are supposed to uphold, says it clearly: “and secure the Blessings of Liberty to ourselves and our Posterity.” The blessings of liberty have been lost, and our representatives — our representatives — are failing to secure them.

    * and everyone’s First Amendment rights, and work ethic/work hours, and freedom to choose whether or not to enter into a contract, and freedom to run businesses as one chooses, and freedom to offer a variety of products or even to innovate new products (affordable insurance coverage plans), and freedom to choose products, and treating us all as hermaphrodites, and causing insurance premiums to skyrocket rather than decline as was promised. [*Deep breath*]

    and the tyranny of government directing us as to how to spend our own money, and the rule of law — when the president bypasses Congress by changing the law with a phone and a pen — and gaining the corruption of the president who rewards his friends and punishes his enemies, and the president setting up websites for citizens to rat out those who speak out against the hideous law (where have we seen such brown shirted people before?). [*Deep breath*]

    and Congress pushing through piss poor legislation by bribing fellow Congressmen with special clauses and exemptions for himself and his constituents, and using the power of the tax code to turn a legal penalty into an illegal tax — which should have negated the entire legislation except that the Supreme Court has now also been corrupted along with the president and the Congress. [*Deep breath*]

    and when Congress asked the president for relief because they realized that they and their staffs could not afford it — well, if those well paid people cannot afford it, what chance do the rest of us have?

    That is what we ended up with when we went completely away from a free market system, heavily regulated as it was. Talk about anti-American corruption, that is the lawless tyranny we now live under.

  • Mitch S

    “‘Cuz it’s never been about healthcare or health insurance, it’s all about destroying our way of life, by any means necessary.”
    “All Leftist strategy to lull the masses into compliant and politically useful tools in the pursuit of utopia”

    Well yes, there are those on the left who are emotionally/ideologically driven that way.
    But the main driver behind the mess is (as Wayne said):
    “all they can think of is keeping their phony-baloney jobs, forever, and making us all pay for their extravagant lifestyle, under the lies of doing what is best for the Collective.”
    That’s our lawmakers!

    It’s easy to sell someone something if they don’t have to pay for it – or think they aren’t paying for it (other than with a vote).
    Much harder to take that away – you must educate them that they will pay for it and pay dearly if they don’t give it up.

    BTW we should remember the healthcare payment system is something that evolved.
    Early in the 20th century there wasn’t much doctors could do for people. People paid as they went.
    Later as medical procedures advanced, “health insurance” grew as an employment perk.
    Then post-employment elderly were set up with Medicare.
    By the 90’s medicine had many procedures, some capable of extending people’s lives but all those procedures come at a cost, and living longer means more medical treatment.
    And of course there are those who game the systems through guile or political influence

    Bottom line is Obamacare isn’t the source of the problem – there needs to be a rethink (for one thing, I think healthcare payment should be separated from employers).

    “I don’t recall people dying in the streets for lack of access to medical care, any time in the last 50 years.”
    Good point.
    One aspect is 50 years ago there weren’t $100,000/yr cancer treatments etc etc – some treatments amazing, some of dubious value (except to the bottom line). People weren’t dying in the streets but there were many who could have lived longer with today’s treatments.
    Still, the other aspect is the claim that more money = better healthcare = better health is generally false.
    The numbers I’ve seen show that wealthy people who spend a lot more on healthcare don’t live longer than a poorer person. All of Steve Jobs’ billions couldn’t save him (perhaps gave him a year or two).

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