Beware the new snake oil salesmen....

Snake oil salesmen....you can find them walking around the halls of Congress hawking their Republican agenda.

Now don't get upset Republican friends.  I'm not saying YOU are a snake oil salesman.  I'm saying you're being SOLD snake oil by the Republican congressmen and Senators who you trusted.  You're being played.  Consider this:

Their #1 agenda item (they say) is to repeal and replace ObamaCare.  They say to you that by stripping out $800,000,000,000 it will bring down the cost of your health insurance, which is now sky-high and has deductibles so steep many of you can't even afford to use it.  Their version will be better they say.  What it will do that they conveniently play down is push up the price of insurance for those over about 55 years old who are now beginning to have some health issues.  Their premiums will go up dramatically after any new Republican plan now being considered is adapted.  

And if you or a family member have a disease or are otherwise handicapped and have effectively been pushed down into the Medicaid-eligible category, you're screwed.  Kids already living in poverty will see their healthcare cut back too, as will the 45% of all seniors (maybe one of your parents, or you one day?) living in nursing homes who depend on Medicaid to survive (and that's no exaggeration).

It isn't just liberal Democrats who believe this.  Read THIS to see why the American Medical Association, hardly a bunch of wild-eyed Bernie supporters, opposes The Republican plan(s).  The American Hospital Association, and not surprisingly the American Association of Retired Persons (AARP), feels the same.  

My Republican friends, you're being sold snake oil.  If your guys in Congress prevail, what you will actually get is NOT what they're selling you.  Reform, definitely, but this isn't it.  This is just the first step towards what they really want, which is a tax cut overwhelmingly benefiting the wealthy.  And if they can't save $800 BILLION on healthcare, they can't get their tax cut.  "Healthcare" is just a pawn in their bigger game.

Tax reform....that's what the Republican leadership calls it.  They want you to believe tax rates will be simplified, loopholes will be closed, and when the dust settles your tax system will be more equitable.  It will still be progressive (the more you make, the more you pay), but the middle class will be better off.  That's all a smoke screen.  What the middle class might save will be negligible if anything.  A tax cut for the rich, the benefactors who fund their political careers, is what it really is.

The Republican leadership will tell you that, yes, their tax reform windfall will go primarily to the rich, but the rich will in turn invest it back into the economy and create jobs.  They'll say it over and over again...JOBS, JOBS, JOBS!  That's straight out of Economics 101.  It's a valid economic theory, but doesn't fit the economic reality we have today.

This is important to understand: 

As of July 24th (yesterday) the 10 year Treasury yield was a very low 2.30%.  A low yield means there is already lots of money out there chasing very little demand.

WE'RE SWIMMING IN MONEY RIGHT NOW, LOOKING FOR A PLACE TO INVEST IT!

American corporations alone (not including individuals) already have $1.9 TRILLION dollars just sitting around.  (Check THIS for more interesting info.)  Giving the wealthy another few hundred BILLION dollars, when they can't even find a place to invest what they already have, WON'T CREATE JOBS!  We'll still see monthly job increases due to the fact that our population/economy is slowly growing and maturing.  But a massive transfer of wealth to the already wealthy won't result in a massive explosion of new jobs.

My Republican friends, you're being sold snake oil.  Your leaders have an agenda they aren't being truthful with you about.  Please stop them, and think this through.

S

Have we put Cousin Eddie in charge?

I feel sorry for my conservative friends who are trying to divert attention away from President Trump and focus instead on what they think is a reasonable agenda.  They articulate something worthy of debate, and then the President dumps on their message with his regular 2 am stream of brain dysentery.

Our politicians all combined couldn't lead a 2-car funeral procession out of a parking lot.  Our healthcare situation is a mess.  The Democrat's answer was ObamaCare, and the best the Republicans can come up with is their ScrewYouAmericaCare.  That's it....Plan 1, ObamaCare; or Plan 2, ScrewYouAmericaCare.  

Where's Plan 3?  "Oh, there isn't a Plan 3" they tell us.  That's because we don't have leaders who can count beyond 2!  What they've proposed amounts to putting a band-aid on a sucking chest wound.  Not only can't they think outside the box, they can't even find the damn box!

Of course we need to control our borders.  Every country does.  But proposing a 21st Century "Maginot Line"-like wall to keep the "murdering, raping Mexicans" out, and then expecting the murdering, raping Mexicans to pay for it is about the most ridiculous thing I've ever head of.  Somebody please enroll Donnie John in a Dale Carnegie How To Win Friends And Influence People course.

Trade agreements need to be beneficial to all involved, but over time they sometime lose their fairness.  Calling all parties to sit down together and negotiate a mid-course re-alignment is reasonable, but that won't work if our Negotiator In Chief is slinging personal insults and threats at the other participants.  Make that a remedial How To Win Friends And Influence People course!

With the end of the Cold War many of our NATO partners let their guard down.  With just a few exceptions they spent their tax dollars on everything but their own national security, thinking America always had their back.  Asking them to step up now and contribute more to the alliance is reasonable, but it should be done in respectful negotiations, not by lining up our allies and lambasting them in public. That was cringe-worthy.

We have many serious issues that need attention requiring a top notch team.  So who does President Trump choose to be on his team?  Gen. James Mattis at Defense....OK, he got that one right.  And Rex Tillerson at State....I must say he's doing much better than I expected (although reports are he's about ready to throw in the towel.)  But the rest of them aren't worth shooting.  Steve Mnuchin at Treasury?  Remember the big economic meltdown back in 2008?  Then we had a team of outstanding economic minds who, together, pulled us through.  Mnuchin was one of those who got us INTO that mess, and certainly not one who has the credentials to get us out of the next one.  God help us!   

Beauregard Sessions as AG?   Does anyone think he'll last the year?  And how about Tom Price, the architect of that great healthcare reform plan that enjoys the support of a whopping 17% of the people?  And last but not least, Betsy DeVos, Education Secretary only because her family is a mega-$$$$$ Republican contributor.  Of all the possible excellent talent he had to choose from, President Trump chose these? *sigh*

As I said, conservatives deserve to have their agenda fairly heard and debated, just as liberals do.  But where are today's composed, articulate leaders like Kennedy and Reagan, leaders who were respected if not always agreed with?  Even hardcore Republicans who have been chewing on their tongues for months trying to defend Trump are beginning to turn on him.  He's an embarrassment!

It isn't necessarily the message*, but Trump as the messenger that is threatening to send the Republicans into the political abyss, to join Nancy Pelosi and her Democrats who have already made themselves at home there. 

I feel like we're living one of those movies where both pilots have flatlined and left the plane, and the passengers, to fend for themselves.   You think Air Traffic Control will be able to talk us down?

S

* Well OK, maybe some of it is the message. ;)

The BIG LIE II

Remember the Big Whopper President Obama told us back in '09?  Of course you do....it's been part of the Republican's talking points ever since.  It's what the Democrats promised us if we would only approve the Affordable Care Act, aka ObamaCare.  As it turned out many of us couldn't keep our doctors, or the old insurance plans we had, either.  BAD DEMOCRATS!

Well, get ready for The BIG LIE II, courtesy of the Republicans this time.  It goes like this:  If we'll just approve the ObamaCare replacement bill now before the Senate, or the one passed by the House of Representatives, our insurance premiums will come DOWN!  DOWN they say! 

Can I get an AMEN?

OK....exhale, engage your brain, and think about that.  Here is the reality:  Your health care insurance premiums are NOT going to come down.  Our population is growing.  More people will need more healthcare, and a smaller percentage of them will have insurance.  The percentage of workers covered by employer-provided insurance is declining.  That's an undeniable fact.  And we are living longer, due largely to better medical technology and better, more effective pharmaceuticals.  Another fact.

This technology and these medicines are expensive to develop and use.  Many Baby Boomers who benefit from this miraculous 21st Century healthcare are also in a precarious financial position.  After 30 years of receiving merit and cost of living raises, they're prime for being pink slipped, their jobs being taken over by younger employees who will happily work for much less.  And to plug any talent shortfall, companies often just call back the very workers they separated and offer them work on a contract basis....for less money and without benefits, of course.  Do I even need to mention the number of jobs that have gone overseas?  More people previously insured are no longer covered.  Fact!

For those still enjoying employer-provided health insurance, it's being watered down.  My personal experience was that in the last few years I had such insurance my deductible went from $500 a year to $1,000, then claims were paid at 70% vs the previous 80% of the balance.  After that my yearly out-of-pocket expense was capped at $6,600, up from the previous $3,000 per person, and if I used doctors outside their "network", it could be as high as $39,000.  Copays per visit went from $10 to $20 ($50 for specialists).  Many people may have insurance, yet they can't afford to use it.  Still, our premiums went up modestly.  Can you imagine how much they would have gone up without this watering down?

With a tightening cap on Medicaid, fewer people in need will be able to get regular health care.  Understand, most Medicaid recipients are children, those with handicaps, and the elderly.  They will still be able to visit hospital emergency rooms for treatment, but the hospitals and doctors will just have to write off any payment for their services as unrecoverable.  This will require them to RAISE the fees they charge those who DO have insurance, putting further upward pressure on premiums.  Again, an undeniable fact.

And without Medicaid, and for those simply without any insurance at all, there will be fewer preventive screenings.  Currently, future chronic conditions can be identified early through regular checkups and treated.  With more people receiving fewer preventive screenings, their conditions will fester and become much more expensive to treat later, costs that will once again be dumped back on society and eventually show up as higher premiums.

It's unlikely IMO that insurance companies will open themselves up to nationwide competition.  The state Boards of Insurance, and the insurance companies, have too much power and $$$ to lose if that happens.  That will be negotiated out in exchange for their acceptance of a repeal/replace bill.

Likewise it will still likely be mandated that American consumers buy their prescriptions from American pharmacies, and not be allowed to legally shop overseas.  Big Pharma is now allowed to charge whatever they want here, which is just about the only place in the world they still can.  We're their cash cow!  They're not going to give that up without a huge fight!

I'll stop there....you get my point.  While ObamaCare has not proven to be the cure-all many had hoped for, the Republican's BIG LIE II will be a giant step BACKWARDS.  The only thing it will do is remove $800,000,000,000 from the Treasury's debt obligation that they can then give (mostly) to the wealthy in the form of a tax cut.  (That's really what this is all about.)

Wise up friends.  Say NO to this slight of hand.

S

Sorry to burst your bubble, but....

"You, go get more lipstick....lots of it.  We'll need to spiff up this pig if we have any hope of pimping it to the American people."

Senate Majority Leader Mitch McConnell has a dozen or so of his hand picked buddies locked in a back room as I write, trying to put together a new healthcare bill they can ram down our throats before we wake up.  When asked by some in his own party when they could see the bill, and how long they would have to review it before a vote was called, he said "a day".  Geez....what a railroad job!

"But....but....ObamaCare....the Democrats foisted that pile on us back in '10.  They...."  I don't care.  All I care about is now.  "Two wrongs don't make a right", as my mama used to say.  Truth is, they don't even care about healthcare.  Their goal is to gut healthcare so as to save enough money to fund their beloved giant tax cut.  That's it, bottom line.

Anyone who thinks they can put together a plan that will preserve the "pre-existing condition" and "no lifetime cap" provisions that everyone seems to like about ObamaCare, while giving us equal or better coverage, with equal or lower deductibles and co-pays, all for dramatically lower premiums, is delusional!  Nothing is free!

Everyone seems to think you have to either back ObamaCare or a derivative, or the Republican alternative.  That's it....pick one.  Both sides are just tippy-toeing around the fact that any meaningful change will require some seriously major changes, changes likely to step on the toes of some extreeeeemly powerful, wealthy interests who want to prevent that at all costs.  Until they are willing to piss off some of these special interests, nothing will change.  And politicians simply don't piss off those who are pulling their strings.  Never.

S

You scratch my back, I'll scratch yours

Did you ever own a fully restored classic car?  No?  Me either....they were always waaay above my pay grade.  But I have known people who did, and they all told me their restoration was a gradual, evolutionary process that took years before their cars were trophy winners.

First they disassembled everything to see what needed to be done.  Then they rebuilt the engine and transmission while the body was being repaired and repainted.  Finally everything was put back together, with new re-chromed wheels and appropriately sized tires.  With a new convertible top and upholstery, it was ready to meet the show judges.

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Stay with me here....Now that a replacement for ObamaCare has fizzled it looks like we're stuck with the old ACA, and that's a problem.  By all accounts it's failing fast.  There are too few insurance companies to choose from in many areas, premiums are rising, and deductibles are so high many people can't afford to actually use the insurance they're paying for.  So instead of just walking away from it and watching it wither, and killing people (literally) in the process, why don't reasonable people work together to FIX IT?

Just like with a classic car, first you see what needs to be fixed.  Then piece-by-piece you clean it up and keep what you can, buy new, better parts as needed, and finally reassemble it to become something that actually works.  It's an evolutionary process, not an overnight quick fix.

They say there isn't enough competition between insurance companies, so why not allow them to compete across state lines?  The GOP campaigned on that idea, and if it can bring down premiums, why would the Democrats object?  (They've always said insurance companies were their archenemies, right?  Here's their big chance to spank 'em!)  Except for the health insurance company CEO with a mega-bonus at stake, why would anyone object to companies competing for your business?  Am I missing something?

They say the pharmaceutical companies are screwing us blind, which is another reason insurance costs are so high.  The Democrats on the Left and now the Tea Party on the Right have always wanted to come down hard on them, so why can't they bury the hatchet long enough to give Big Pharma an ultimatum?  "Get your prices here in America in line with the international market, or we'll free up consumers to legally buy their prescriptions overseas.  No more official government cover."

Line-by-line, read the ACA, keep it if it's working, and change it if it isn't.  Have an ongoing amendment process that keeps constantly striving to improve it.  The old system (pre-ObamaCare) was slowing failing us, so it was just a matter of time before something new had to be tried.

They say if everyone walks away from a negotiation just a little miffed, it was probably a fair deal.  Forget the concept of "all or none".  It's time for some give and take.  Americans seem pretty fed up with the extremists after their sorry debacle last week, so this might be a good time for moderates to get something done.

We have us one helluva mess.  Something has to change. 

S

Wha...what? Flying pigs?...Icicles in Hell?...

Stubborn as hell and it never forgets.

Do you understand what's happening with this on again / off again healthcare bill about to come to a vote in Congress?  I think I have it figured out.  Here's my take:

The Red State congressional parasites have promised their constituents a Trillion Dollar tax cut, cause, you know, their folks need more $$$.  The first step to doing that is to trash ObamaCare.

The Blue State congressional parasites have promised their constituents more healthcare benefits with ideally even bigger subsidies.  They don't care what it costs because their constituents by-and-large won't be the ones paying for it.

Right now ALL House of Representatives Democrats (the Blues) will vote "no" because it cuts too deep, and many Republican Tea Party-types (the Reds) will vote "no" because it doesn't cut deeply enough.  Talk about strange bedfellows!  The bill is expected to fail.  But if by some miracle it passes, what then?

Then it's on to the Senate, where it's even less likely to pass, for the same reasons mentioned above.  The Republicans want their tax cut, dammit!  There are yachts that need buying!  They don't care who they have to whack to get it.  The Democrats just want their blank check.  Stalemate.

So what if the few moderate Democrats along with the few moderate Republicans sat down together and agreed to strengthen the good points of the ACA, aka ObamaCare, toss out the parts of the ACA that smell, and try to keep the expenses fairly neutral....no blank check for the Dems, and no 1% welfare check for the GOP?  The fringes of both parties could just go to their respective corners and throw their little tantrums.

And to get President Trump to sign it, they can call it "DonnieJohnCare".  He'll love it!  He'll think it's FANTASTIC, just TERRIFIC!  What do ya think?

S

I worry about my friends, Bob

And I owe it all to Hanz and Franz

Health-wise I've always been pretty lucky.  I've been told I come from a pretty healthy gene pool as very little has ever gone wrong with me....until recently.  I don't smoke, drink only occasionally and in moderation, no drugs, and I was always in pretty good physical shape, even though I never crossed paths with Ah-nold at any gym.  (I did wander into a gym once by mistake, though.)  

I did, however, have several back-to-back detached retinas a dozen years ago, and I came semi-unglued at age 64 when they discovered I had an immune system condition as well as heart arrhythmia (my heart was beating too slowly), necessitating a pacemaker.  Fortunately, thanks to my wonderful wife K, who had a corporate job with insurance (with me added as a dependent), those pesky little boo-boo's cost me surprisingly little out of pocket.  Not everyone is as lucky as me, though.  Here are a few examples of people I know personally who are in truly bad shape, both physically and financially:

My masonry contractor, let's call him Bob, has suffered mightily from kidney stones for many years now.  He's had all the tests, tried multiple doctors....everything....but they haven't yet been able to fix him.  They've given him pain meds and just told him to suck it up.  As his private health insurance carrier eventually jacked his rate up to $1,600 per month he had to let it go.  It was either food for his family or insurance.  

Bob is an American of Mexican heritage and still has relatives back in the old country.  Out of desperation Bob recently became a "medical tourist" (people who travel to another country to have needed surgery because it is so much less expensive than in the US).  He said the doctors and his hospital in Monterrey, Mexico were surprisingly good, but still, his surgery was only partially successful.  He's still hurting and still has no insurance.  I worry about my friend Bob.

~~~~~~~~~~~~~~~

I once had a window washer, let's call him Bob, who came to my house regularly to make sure I could see out.  I didn't mind washing my own windows, but all I ended up doing was rearranging the dirt.  Anyway, Bob was in his early 20's at the time, and in conversation told me he worked 20 hours a week at Kroger's (grocery store) in order to have insurance, and then spent the rest of his time washing windows.

A few years later I visited with him again and he said he had to quit his Kroger job as his window washing job became a 40+ hour a week career he couldn't pass up.  I asked what he did for insurance and he said he was without.  He said if he got sick he was just going to go to the emergency room and hope for the best.  At his age I could tell "getting sick" was the last thing on his mind.  I heard some time later that he was involved in an accident (I believe there was a motorcycle involved) and could no longer work.  I don't know where he is today, but I still think about Bob.

~~~~~~~~~~~~~~~

The foreman at the custom cabinet shop we used, let's call him Bob, was in his 50's when he had a stroke.  Like many small businesses, Bob's boss couldn't afford insurance for his employees.  Bob was airlifted to a hospital in Plano, Tx where they stabilized him, but he was left semi-paralyzed.  After several weeks there (and knowing Bob was going to be a charity write-off) the hospital finally worked with Medicaid to find a rehab facility that would take him.  The last I heard Bob was little improved.  I worry about my friend Bob.

~~~~~~~~~~~~~~~

There are lots of "Bob's" in this country who are hurting and have no insurance.  Sometimes they have no insurance because they couldn't afford it, sometimes because they were foolish.  Notice I said all these people were working.  They weren't lazy bums who were looking for a handout, as many imagine uninsured people to be.  They just didn't have the good fortune of having a smart, hard working wife employed by a large, deep-pocketed corporation to carry them on their health insurance like I did.  Fate is too often fickle like that.

We have a lot of sick people here who compassionate Americans IMO shouldn't turn their backs on.  We're better than that.  But what to do?  I don't know the answer, but I'm confident that the Republican's Ryan/TrumpCare bill now making its way through Congress isn't it, nor is ObamaCare, which they say is now itself on life support.  To those who would rather have the Almighty Tax Cut a slimmed down healthcare bill promises so they can buy another shiny new gadget, I hope they'll think about my friends Bob when they're out toy shopping.

S

NOTE:  These are all absolutely real people I know.  If any of you reading this are actually named Bob, I suggest you stay inside today.  ;)

Decisions, decisions....

Yes, healthcare again.  NO, DON'T HANG UP!  THIS IS ACTUALLY PRETTY INTERESTING.

Congress (the House of Representatives) should be taking a vote this week on whether they'll be adapting Ryan/TrumpCare or sticking with ObamaCare, which it seems all agree will soon be/is on life support.  The Right is hoping for the former, and the Left (Bernie & friends) would prefer something more like the single-payer (universal) healthcare system they've had in the United Kingdom since 1948.

So what exactly is the UK's system (the NHS) like?  I'd heard the doctors and nurses, the technology, and the facilities are all first rate, but the wait time to be seen by a doctor was very long.  To get to the bottom of it all I corresponded with a British friend* and asked him to give me a quick overview.  I trusted him implicitly and knew he would give me the unvarnished truth to the best of his knowledge.  His response:

First, the NHS is a mandatory insurance scheme paid for by National Insurance contributions, a tax for all intents and purposes.  Almost all prescriptions are included for a flat fee of approx $10US each, with exceptions for the young (<16) and the "more mature" (>60), with a few other special exemptions, too.  One option is a Rx pre-payment plan costing roughly $125 per year which covers all your meds, regardless of how many you might have.

All doctor and hospital treatment is included, as are many optical and dental services.  Doctors, dentists, and "opticians" (optometrists) are all self-employed and may be either working entirely for the NHS under contract, entirely private, or a bit of both.  About 8% of the population also has private insurance over and above their NHS coverage, which generally gets them perks like quicker consultations, private hospital rooms, etc.  (He said it really amounts to not having to rub elbows with the common folk in the waiting rooms.)  Almost all feel there is no difference in the care received, although a few would debate that.  If a doctor has a good reputation and a thriving practice serving the 8%, he can probably make more $$$ by going entirely private than with a NHS contract.

The biggest grumble is indeed the wait time to be seen.  Of course all patients are prioritized, just like here, so emergencies get immediate attention while non-emergencies could be in for a fair wait.  Elective surgeries can take (many months) longer to schedule than here, so you might be hobbling around a lot longer on a bum knee, but at least there will be $0 due when you're finally patched up.  

Another common complaint is that the NHS is in places understaffed.  All this varies depending on where you live, just like service in the US varies depending on if you live in a big city or a smaller town.  On the plus side, paperwork there is nil....just show your eligibility card.  That's it!  *take note Aetna!*

My friend pointed out that, essentially, National Insurance and the NHS is a non-profit system that covers everyone.  The nature of the system means that drug manufacturers have to reach agreement with the NHS about what their prices will be, and as a near-monopoly the NHS can haggle for better prices than private hospitals or doctors can here.  This is largely why treatment costs there are so much lower....the non-profit side combined with the fact the NHS dominates the market.  In the US a very large portion of the money we pay goes to the sort of overhead that any privately-run system has....large salaries for health insurance and pharmaceutical company execs, dividends to shareholders, medical billing and the inevitable write-offs, and so on. 

Now for some numbers** :  The United States spends approx 17.1% of its GDP on healthcare (public and private combined), or about $9,403 per person, which still leaves us with about 12% who have the only option of going to an emergency room for care, which they will likely never be able to pay.  The United Kingdom spends approx 8.8% of its GDP on healthcare (public and private combined), or about $3,377 per person, which includes care for every legal resident.  

On a parallel track, the total tax burden on the average American is 26% of his income, and 32.6% for the average UK resident.  Essentially the top income earners here would come out ahead paying a lower tax rate, while the rest of us would probably do better paying higher taxes but receiving all-inclusive healthcare. 

Just as there is considerable political pressure to cut healthcare costs here, the same applies there.  The Republicans here and the Conservatives (Tories) there are looking to reign in costs (ie: coverage).  Both are having some success, taking some services off the table, although incurring the wrath of many voters in the process.  I will say that every single Brit I have ever heard discuss their system said they were overall "satisfied" or "very satisfied" with it.

It seems to me that if you have coverage here in the US (subsidized) by your employer, if you have ample financial liquidity to pay for all your prescriptions, the ever-increasing co-pays, deductibles, and out-of-pocket expenses, and if you believe your job is rock-solid stable (is there such a thing anymore?), you might want to just leave things alone.  But if your situation is anything other than that, the security of a British-style system might look very enticing.  Also be aware, as I understand it, those here over the age of 47 will be especially hard hit by the proposed Ryan/TrumpCare, so be prepared.

Finally, I ran across this article while doing my research comparing the UK and US systems by someone who has used them both.  It's definitely worth a read....very interesting.

Just something for you to think about.

S

* Thank you, Sir, for your invaluable insight.  :)

**  Exact numbers are hard to compare.  US, EU, various research groups, etc, differ slightly.  Some numbers, for example, are from 2015, and some from 2016.  Still, the variations are minor.  Tax liability numbers are as close to "apples-to-apples" as I can find.

Healthcare in America....where are we headed?

Yesterday a friend of mine, who is in the healthcare field, asked on her Facebook page what should be done regarding the "repeal / replace" controversy now raging.  She and her other healthcare professional friends agreed some form of coverage for everyone is absolutely necessary, while her more "conservative" friends said "no way". 

First, a personal disclaimer.  I'm covered by Medicare, which has worked great for me, and my wife, who is now once again a full-time college student, has a group plan offered through her university.  And after her college days, as a last resort, she is a disabled veteran and has VA care available to her.  In short, I have nothing personally to gain or lose in this debate.

The argument I heard from the conservative "Tea Party-types" was that they resented being told they MUST buy insurance, and would be perfectly happy if it would just go back like it was pre-ACA / Obamacare.  My strong suspicion is that they have secure (for now) jobs and enjoy employer-provided insurance, or are older and are covered by Medicare.  Both see ACA as just a giant wealth transfer from them, the relatively affluent, to the poor.  There's no upside to them if there is a replacement plan.  They would prefer repeal, period.

Those in the healthcare field almost universally say they see the desperation every day on the faces of people who can't afford insurance or the ER medical care they've been billed for and are absolutely begging for their charges to be forgiven by the hospitals and doctors.

My observation is this:  The Tea Party-types know in general terms that poor people can't afford healthcare for themselves or their families, but they don't actually know any of them.  They just can't relate.  I can.  During my 40+ year career in homebuilding I saw on a daily basis plumbers, electricians, painters, roofers, etc who I'm certain didn't have health insurance.  

They may work 40 hours one week, and just 30 the next.  If the economy tanks, they may have no work for weeks at a time.  They're always on the brink of desperation.  They work hard....they certainly aren't slackers. They don't get a yearly two-week paid vacation, or have a 401K, or health insurance.  That's just the nature of the construction industry.  Are we just gonna kick people like them to the curb?

In the old days you worked 40 years for your company and retired with a gold watch.  Today if you have seniority, which probably came with yearly pay raises for decades, you're now at the TOP of the pink-slip list.  You're good as gone, to be replaced by a 25-year-old with a MBA who will work for 40% less than you're making.  And if you're 58 and find yourself with more and more ailments, and you're suddenly unemployed, how are you going to afford health insurance?  Who wants to insure you?

I know plenty of people who are / have been in that very position.  A secure job today is no guarantee of a secure job tomorrow.  Remember that!

"Oh", the Tea Party-types say, "they won't be able to deny you because of a pre-existing condition."  Isn't this a classic example of having your cake and eating it too?  They abhor the ACA, yet want to cherry pick the parts they want to keep....without paying for it.   Sorry, but life doesn't work like that.  "You'll still get a [smaller] subsidy" they say.  Again, they're UNEMPLOYED!  They have no income!  A [smaller] subsidy is worthless to them....it's like being promised a BIG piece of NO pie.

I laugh incredulously when they say they'll expand Health Savings Accounts that people can use to pay for their health insurance and deductibles. They just don't get it!  Lower income people don't have the luxury of putting a few hundred dollars a month into a HSA.  They're living hand-to-mouth as it is.  It's like Marie Antoinette telling her hungry French subjects "Let them eat cake."

The Tea Party-types ask how fair is it for them to pay into an insurance scheme that benefits someone else?  So let me ask, why should residents in West Texas pay higher homeowner insurance rates to make up for their fellow-Texans who have suffered hurricane damage on the Gulf Coast?  Why should I pay for an interstate highway in Ohio when I've never even been to Ohio?  Why should I pay school taxes now that my youngest daughter is 35 years old?  Because it's for the public good, that's why. 

If we average the cost of healthcare across all age groups around the country, the young will indeed pay more now than they could have before the ACA, but they'll make it up later in life when they'll need healthcare and get a sweet price break.  That's how a "risk pool" (insurance) works, and there's nothing more free-market than insurance.  

Yes, I hear those who point out that insurance is optional, but not buying in means no benefits.  Are they going to be the gatekeeper at the hospital door that turns away the hysterical mother with no insurance cradling her deathly ill child?  And if the mandate stays that requires hospitals to care for anyone who walks in, whether they can pay or not, how much longer will it be before marginally funded hospitals start closing? 

I don't know how this will ultimately play out, but times have changed, and we must change, too.  We need to find a way to provide healthcare for all our citizens.  They can't give healthcare away, I understand, but anointing some to enjoy the American "good life" while condemning others to always being on the outside looking in is not what America should be about.  America should not have a caste system.

Not everyone can have an enviable IQ, be well educated, have a secure, high-paying job with benefits, and just skip merrily through life.  If they could, who would be left to change our oil, or build our houses, or maintain our sewer systems?  *any volunteers?* 

It won't be easy, and it won't be cheap, but we will be a stronger, more internationally competitive country if we're healthy and working smart.  We MUST find a way to care for our own. 

S

LOOK....SQUIRREL!

...which suits Washington juuuuust fine!

I see the trend on social media these days is to swear off political posts.  "Enough already!  We only want good news for a change."  Well, I'm pretty sick of this Washington circus, too.

Only one problem:  The circus never takes any time off.  The circus is busy 24 / 7 / 365 screwing us over.  But if I take time off from posting political stuff, no one will know how bad we're getting ripped off, 'cause y'all will be too busy watching butterflies and sharing artichoke recipes.  So go ahead, watch butterflies....make a politicians day!  If we aren't watching them, they don't even have to pretend like they give a hoot about us.

We know all about the wall Mexico is going to pay for (but isn't), and the ban on immigrants from seven mid-east countries (never mind that they picked the wrong countries), and the new replacement for Obamacare (that they haven't a clue how to do), and the three million illegal voters who almost cost Donnie John Trump his election.  But that's OK, 'cause it sounds good on TV, right?  The folks back home think they're being looked after, and that's enough.

Meanwhile, Steve Mnuchin, (inmate #288356 if I had my way) is on his way to being our next Treasury Secretary, and Steve Bannon has his fat ass parked on President Trump's shoulder and is whispering sweet nothin's in his ear.

*Have you noticed that our Billionaire President is appointing other Billionaires to his cabinet and charging them with reforming the system that made them all Billionaires?*  

"Uhh, don't worry....nobody's watching.  Today why don't we gut that financial regulation thang that's gettin' in our banker buddies' way.  Oh, oh, and that Consumer Protection outfit that's protectin' consumers....consumers don't need no stinkin' protectin'!  Let's whack 'em both!"

Now don't get all smug, Democrats.  Y'all are swimming in the sewer right there with them.  You sold out to the special interests and didn't' even try to hide it!  You were afraid Lil' Bernie Sanders might muck up your Grand Plan, so you just conveniently slipped Hillary Clinton 500 free convention delegates.  "Order the confetti and balloons.  Par-tay!"

Fortunately for me I actually enjoy calling the bums out when I see them trying to put lipstick on their respective pigs.  

So read, don't read....your call.  But please, do me one favor.  Keep posting your funny memes and videos of stupid tricks gone awry.  I love that stuff.  :)

S 

Now you see it, now you....just kidding. You're NEVER gonna see it.

A few years ago we did a fairly sizeable home remodel for a client.  In conversation I learned that the Mrs was a now-retired hospital CFO.  (Her hospital was absorbed into another even larger system, and she took her bonus/payout and retired.)  I shared with her my frustration trying to figure out hospital and doctor statements, and she just chuckled and said, "Of course you're frustrated.  That's by design."

She told me how hospitals had a MSRP Blue Book (my term, as I can't remember what she actually called it) which listed their charges for everything you could possibly imagine.  "Appendectomy $19,300; double heart bypass $94,000; set broken arm $12,600, aspirin $10", etc (I can't remember her actual numbers).  

But then she told me their dirty little secret:  ALL their numbers were totally made up!  They bore no resemblance at all to their actual costs.  There is no industry standard.  And every other hospital had their own Blue Book, too, with their own totally made up prices, and they often differed widely.  That's why you'll hear TV investigative reporters tell of how one hospital charges $300 for a mammogram, while another across town charges $2,700.

Of course insurance companies have contract pricing where they pay MUCH less, but if you have to pay yourself, this is what they bill you.  Some pay, some walk it entirely, but some come back to negotiate (and the hospitals allow themselves LOTS of room to negotiate).  It's a giant shell game!

Some doctors do something similar.  You call a doctor and ask if they take your brand of insurance and are told yes, so you make an appointment.  A few weeks later you find out from your insurance company that the doctor charged more than the "usual and customary" fee, and that the balance is up to you.  Gee, thanks for telling me up front, doc.

Ditto for prescription drugs from your insurance plan or Medicare drug supplement.  They cover what is on their "formulary" list only.  Their what?  If it isn't on their list, you're SOL.  (Shit Out of Luck)  And they list page after page of things like hydrothialomicizinetine trididodickyluckypucky.  WTH?  What happened to "Lyrica" or "Crestor"?  Sadly this is the way our world works today....you're led to believe one thing, only to find out later the fine print screwed you over.

We little guys don't stand a chance!

So now they're going to REPEAL AND REPLACE Obamacare.  OK, great, by all accounts it needed to be overhauled.  But please tell me how they're going to get all those various interests, each with their own proprietary fine print, to agree to a viable replacement?  Each will be maneuvering to throw the other under the bus first. (No honor among thieves, you know.)  And it will eventually have to be voted on by Congress....yes, bought-and-paid-for Congress.  *bend over folks*

There's fine print everywhere....buried in that 8 page credit card agreement, that 75 page mortgage document, your homeowners/renters/auto/life insurance policies, your auto loan agreement, that investment prospectus....everywhere!

Here's the deal:  most businesses today don't WANT you to know how they operate.  They LOVE doing business in the shadows.  Transparency is the LAST thing they want.

Ever hear of the Consumer Financial Protection Bureau?  It was an outgrowth of the financial meltdown back in '08.  Its supporters will tell you it exists to slap down businesses that take advantage of unsuspecting consumers (ie: non-lawyers who can't understand all that legalese/fine print).  Detractors, such as the Big Banks, the US Chamber of Commerce, and I'm sad to say the Republican establishment, will tell you it "interferes with their ability to conduct business as they feel they need to", and besides, regulations are JUST DOWNRIGHT UN-AMERICAN!!  *saluting flag*

Seems to me if the Big Banks, the US Chamber of Commerce, and the Republican establishment (and probably more than a few Democrats, too) would behave the way their mamas taught them, there wouldn't be a need for a Consumer Financial Protection Bureau.

What you DON'T know WILL hurt you, or at least COST you.  Caveat Emptor now more than ever, my friends.

S