Archive for the ‘obamacare’ category

The Big Fat Lie

July 25, 2017

Exaggeration and Hyperbole are staples of public speaking and popular literature. President Trump, since day one of his Presidency, has added these speech forms to his Presidential Addresses. It appears the possibility of being tagged with multiple Pinocchio’s is not a deterrent for America’s “communicator in chief”.

Yesterday, in a staged photo op, President Trump spoke out over the Senate “repeal and replace” stalemate. Pointing to the gathered group (J Crew looking group), the President asserted that they were Americans who had incurred the injurious nature of the Affordable Care Act (Obamacare). The implication was that here, in flesh and blood, were Americans who were harmed by ACA and wasn’t that proof positive that repeal and replace was necessary?

Maybe, but what about the 22 million Americans who the Congressional Budget Office say will lose healthcare coverage should either the Republican House or the Senate legislation pass. Is that Exaggeration or Hyperbole?

No, Deception or Misdirection would better describe the President’s statements. For someone who appears to have no regard for any statement’s accuracy, President Trump is more complex than just a “truth stretcher”, the President is purposeful and says what ever is necessary, no limits considered, to achieve his goals.

So, as if to say the misdirection statements about how many Americans would benefit from Obamacare were not enough, the President stood before this group and into the camera said, Democrats lied about the Affordable Care Act in order to get it passed, “every single thing they said was a lie, a big fat lie”. Hmmm.

Liar, liar, pants on fire.

The Presidency appears in a race for the bottom. What more outrageous mistruth or magician’s misdirection will President Trump put forth? The larger question might be, how much more exaggerations and hyperboles will Americans accept before deciding to dismiss all statements from our communicator in chief?

Don’t Blame Trump

July 22, 2017

The first six months of the Republican Administration has not lacked for fireworks. Most pundits, however, would describe this rare period of Republican control as a “nothing” burger. If so, who’s to blame?

President Trump has blamed Democrats and the “fake news” media. The Republican controlled House has blamed the Republican controlled Senate while the Senate has quietly pointed to the lack of White House leadership. President Trump when not blaming Democrats counters, instead, claims the first six months have been the most successful first six months ever!

What else would you expect the “mistruth commander in chief” to say?

The frightening aspect of this question is that many claim that the Trump Administration and Congressional Republicans could have passed much of their legislative objectives had they approached matters differently. And then there has been that pesky “Russian thing”, the investigation into Russian collusion with the 2016 Presidential election. Hmmm.

For Americans the way things have progressed could be a blessing. Both President Trump and the Republican controlled Congress have been exposed as what they really are, mean spirited, unprepared to govern, and hand maidens of certain wealthy interests.

The center piece of the hopeful Republican legislative program has been the Obamacare repeal and replace. As Congress processed this legislation, slowly but never the less, step by step, it has become clear Republicans lacked a plan and more importantly were clueless over improvements. “Beautiful healthcare Americans can be proud of” instead turned into “healthcare that gamers and the very rich can be proud of”. Replacement legislation passed in the House by a single vote and floundered in the Senate altogether. Not surprisingly, tweak after tweak fell short too. Why?

Each of the Republican healthcare proposals failed in the same way. Each insured fewer Americans, provided less coverage, and benefited the very wealthy. So, how did President Trump get it so wrong?

President Trump is not the architect of this Republican farce. The President is more interested in the pomp that goes with the office, flattering headlines in the media, and a slam dunk reaction win in 2020. There is not much more substance than that.

So don’t blame President Trump for proposing defective healthcare replacement legislation or proposing tax reform which masquerades as (you guessed it) tax cuts for the rich, or for the appointment of Neil Gorsuch to the Supreme Court. Each of these topics is that straight out of the Republican handbook and 100% the responsibility of the Republican controlled Congress.

Troubling is the realization that the Affordable Care Act (Obamacare) is far from perfect legislation and is badly in need of fixes. And who can not agree that the US tax code is more aptly a “jobs” program for accountants than a fair method of raising government revenue. But these goals were not part of any Republican agenda.

The news media has published plenty of reports claiming Trump White House dysfunction and most of it seems well deserved. Never the less, the greater tragedy would be to hold Congress blameless and clear of the ugliness and mean spiritedness of President Trump’s rhetoric.

Democrats had better be taking notice and realize it is not impossible that they will be given the reigns of Congress in 2018. Democrats should be wondering, WWDD?

Close To Greatness

July 14, 2017

Republicans are running the ship. The GOP controls the Presidency and both Houses of Congress. What more could any party want if they wished to leave their imprint upon America. Each day, however, Americans are observing a President and a Congress aim at greatness but suddenly swerve away, missing the mark by a mile.

  • The “Healthcare” train went off the tracks quickly. Instead of focusing on premium and drug costs, the GOP struck up the “repeal and replace” band only to find they possessed no consensus on “replace”. The one attempt at attacking cost was instead diverted to bait and switch. The GOP offered to sell “stripped down” policies, as if they were Obamacare quality, for lower price. That was their version of cost reduction. Would you buy a car with no passenger or back seat (just the open space) just because the price was slightly lower?
  • Even more obvious as a ripe target is the cost of prescription drugs. What other country in the world makes drugs and sells these patented compounds in other countries for less than they sell the exact same materials in the US? The GOP could have seemed genuinely interested in the well being of Americans had they not taken the “repeal and replace” course.
  • The “Tax Reform” train, on a different track, seems destine for a similar miss. Anyone who prepares their own taxes knows full well how complicated a reasonably straight forward process can be. But “tax reform” is political code for “tax cuts”. And if you are wondering how much you might realize, don’t waste your time, the GOP tax cuts are about those who don’t need them, the wealthy.
  • Infrastructure investment, like building roads, bridges, harbors, and airports, is a time proven method to improve productivity by modernizing shared means necessary for economic growth (read jobs). Infrastructure investment is also a popular method to just put people to work regardless of whether the work produces any economic return. Under certain circumstances, even just employing people can be a good thing.
  • Not, apparently, with this Administration. Infrastructure investment means privatization and transferring more wealth from tax payers to private investors.
  • Along these same lines, the growing crisis around student loan debt is viewed as another opportunity to use private enterprises to assist the financial needs of students seeking higher education… at a substantial profit.
  • If training skills and higher education are needed to make workers more employable and more productive, then why would government add a layer of profit from loan administrators? Why would government treat student loans differently in bankruptcy cases than if someone bought too much house or too many cars?

Americans may have been frustrated with these situations in 2016, and decided Hillary Clinton and the Democrats were not the route to fixing them, hence Donald Trump became the 4 5th President and the Republican Party got control of both Houses of Congress. With seven months of this new Administration, Americans instead are seeing “greatness” by-passed in favor of wealth transfer from the average American to the wealthiest Americans. Hmmm.

Healthcare Debate Show Down?

July 10, 2017

Republicans have fought mightily to pass legislation which “repeals and replaces” the Affordable Care Act (Obamacare). Divisions within their own party have prevent Senate ratification of a repeal and replace, and now back from the 4th of July holiday, Republican Senators are back to the grindstone. Will they be successful?

Unlikely, unless one counts failure as success.

Medicaid expansion, thanks to Obamacare, has provided many more Americans with healthcare than before. These voters have made it known that they would not be pleased with Republican Senators were this coverage to disappear. Hmmm.

Pre-existing condition coverage is another “must have” option in voter’s minds. Relatively speaking this is an expensive option and Republican law makers are worrying how they can pay for that option and still provide a tax cut. Hmmm.

And the thinking that no one should be required to have healthcare insurance comes also with the freedom for companies to elect not to offer their employees group insurance plans. This “freedom” might have Americans beginning to wake up to the possibility that although they may have health insurance today, tomorrow they might be laid off or their employer may just choose not to offer coverage. In both cases these Americans will be out of luck.

But what seems to have gotten the GOP’s attention is not the impact poor coverage or no coverage at all will have upon Americans, it is the phasing out of Federal Government funding of the Medicaid expansion and the dawning that States would need to increase their contribution to maintain coverage.

What? States would need to raise taxes or become responsible for dropping State residents from Medicaid rolls.

This line of reasoning reflects a morally bankrupt political party. Public shaming has not worked to date in changing Republican thinking. Maybe the political reality and risk of being voted out of office will have a different result.

The Smell Of Coffee

July 5, 2017

Six months does not make a year, and a year does not make a four year term. President Trump (and his advisors), however, are waking up to the reality of governing. Much of President Trump campaign’s boastful rhetoric have already been exposed as misguided myths. Too little time has passed to fairly pass judgement upon what President Trump has done or what he has not. A quick look is not encouraging, however.  Maybe his staff and advisors are saying “pass the coffer”.

On the domestic front, President Trump has continuously blustered about both creating and retaining American jobs. There is little evidence of either, and as important, his budget proposals have circled thousands of current Federal jobs for elimination. I wonder whether the President is using “new math”?

And just in case the Administration has not been looking, internet giants such as Amazon have been marching forward with “job eliminating” new efficiencies. If Trump’s advisors are honest with themselves they should marvel at how resilient the economy they inherited really was.

The Obamacare “repeal and replace” has not turned out to be a “walk in the park”, done, and mark that one off the list type of initiative. Funny but most Americans want the benefits of Obamacare. Further, once fact checked, Republican criticisms melt under a healthy dose of facts and transparency. And best of all, voters have seen what was always there. Republicans are only interested in the tax cut which will accrue for the wealthy. The specific American Health Care Act benefits, if enacted, will be the bare minimum necessary to pass the AHCA.

The campaign’s vitriolic immigration slogans have also been shot full of holes. The top priority Mexican border wall has gone no where after just about everyone involved has declined to endorse the efficacy of addition fencing. Congress has twice chosen not to appropriate money. And, more telling is that there are no indications that illegal immigration has increased.   Even more telling is that business leaders are calling for more temporary labor since they cannot find enough American citizens to fill jobs ranging from technology to agriculture to domestic occupations.

Foreign affairs, probably, best characterizes the Trump Administration ineptness. Trump’s shoot from the hip style has proven to be grossly ineffective. Foreign leaders who possess much less power (ships, soldiers, and planes), have learned to survive employing long term strategies and short term diplomacy. Countries such as Germany, France, Japan, China, and India have over the years cleverly closed large parts of their economies to American companies. These leaders are not going to concede these advantages to President Trump’s taunts and threats.

The President’s decision to withdraw from the TPP and the Paris Climate Accord, both actions were designed to appeal to Trump supporters domestically, simply convinced leaders around the world to say little, work together, and forget about the US until it regains its senses.

His claims of “bombing the S**t out of ISIS and quickly ending the conflict has been shown bogus, but what will he do with what follows ISIS? In Afghanistan, the Trump Administration appears on the verge of increasing troop strength with no known strategy for ending the conflict.

North Korea was to have melted away after President Trump became “buddy-buddy” with China’s President Xi. Today, after North Korea demonstrated ICBM capability President Trump looks to more people, simply a king with no clothes.

There is, of course, plenty of time for future world events to prove President Trump’s blustering prescient.  I wonder whether his staff will up their coffee intake in order to get a real grip on reality?

A Message Worth Repeating

July 1, 2017

The Washington, DC “goings on”, if they were not potentially so serious, would be great amusement. The President has given new life to the word “boorish” ceaselessly demonstrating coarse, tasteless, and crude manners. The President also appears over his head in leading the sprawling executive branch.  The President prefers inviting as much personal flattery as he can coax from his subordinates and supporters. Hmmm.

Not to be outdone, the GOP controlled Congress seems intent upon matching the President’s dysfunction (however not yet his boorishness). This past week the House passed legislation aimed at speeding up the detention and deportation of illegal aliens.

The bill’s sponsors pointed to dangerous criminals like the Salvadorian gang MS-13 as an example of why this legislation was so urgent. MS-13 is a ruthless organization and its members deserve to be deported if not outrightly jailed. But, the estimated 10,000 MS-13 members represent a mere one tenth of one percent of the illegal aliens living in America. Comprehensive immigration reform would seem a more logical priority.   Using MS-13 as the post child for rounding up innocent undocumented aliens is a misuse of the trust Americans place in Congress.

This legislation simply hints at how dysfunctional Congress has become. A better example can be found in the “behind closed doors” debate over healthcare. Republicans have uniformly vilified the Affordable Care Act since its enactment, now find that far more Americans favor the Act than find fault with it. Not surprisingly, Republicans have cried for repeal of Obamacare for years while never expressing what they would offer to replace it. Now that it is their chance to repeal and replace ACA, the GOP cannot agree on what the replace should be.

So why do these themes bear repeating?

Following the President’s recent twitter outburst, President Trump not only showed his boorishness when he attacked two MSNBC talk show hosts, President Trump also brought into question his “mental” fitness for office. For those who do not support Donald Trump as President, the tendency to wonder if he might be removed from office, not through impeachment, but through “fitness to serve” criteria seems promising.

Those who hold this view might say, “who cares, just get the bum out of office”.

While this action may ultimately be necessary, President Trump’s removal is not the panacea it may seem. His successor will be Vice President Pence who will be a non-thinking supporter of the GOP controlled Congress. Repeal legislation would surely pass with a President Pence as would also a huge tax cut for the wealthy.  Ironically, President Trump’s dysfunctional behavior’s unintended consequence has been to delay most legislative action.

Our American democracy is responsible for Donald Trump becoming President. There is no one else to blame but ourselves.

GOP controlled Congress, however, arises largely from “gerrymandering” where House districts’ boundaries were skewed shamelessly to favor GOP candidates. (The Supreme Court has agreed to hear a case challenging some of the most egregious district constructs.) In both cases (the Presidency and the Congress), the process to improve functionality begins at the ballot box.

President Trump clearly represents a distraction and potentially a danger to be sure. The Republican Party, on the other hand, is not of one mind (conservatives, libertarians, and moderates) and without a strong opponent like the Democrat Party, the GOP is poised to fracture into warring against each other.

Americans concerned about President Trump should, instead of wishing for a President Pence, focus upon the 2018 election and return control of the Senate or the entire Congress to Democrats, if for no other reason than to minimize the damage until the Presidential election in 2020.

Vice President Pence will not act in a boorish manner, but his cleverness and conservative heart would go well with the current mean-spirited GOP controlled Congress.

Be careful what one wishes for, for our dreams sometimes turn into nightmares.

Living Ones Priorities

June 25, 2017

The “repeal and replace” saga, brought to America by the Grand Old Party (GOP) clearly underscores the priorities of Party leaders, and dare I say, the big money interests who make it all happen. So why are Republicans against healthcare?

The answer is Republicans are not against healthcare, healthcare just gets in the way of what they seek.

The Affordable Care Act is only a slight variant of what the US has had for decades. Health insurance companies are the same, hospitals are the same, doctors are the same, and drug companies ditto. ACA changed the individual market’s healthcare delivery model by specifying “essential” healthcare services which must be covered for a healthcare policy to be eligible for government subsidies. (No more catastrophic only policies).

ACA defined what “basic” healthcare might be. For non-group policy holders, these individual consumer could purchase one of three types of policies, each differing only in price and amount of co-pay/deductible.

ACA also added a new route to providing healthcare insurance coverage. ACA expanded the eligibility definition for Medicaid and found millions of Americans who previously could not afford basic healthcare and had not qualified for Medicaid.

What could be so wrong about ACA (Obamacare) to drive Republicans to focus so strongly on repeal and replace efforts?

We hear much about the price of individual policies with year over year huge increases in premiums. But for those who earn more than certain amounts and do not qualify for subsidies, that is a problem. Surely, however, there are other means to convince insurers to set more reasonable rates. (Remember these same insurers who are announcing their withdrawal from certain States’ individual policies market are still quite happy to cover “group” plans in the same States.)

We also hear about returning healthcare to “patient centered” insurance and removing “government” from the place between the patient and their doctor. Hmmm. And what is the difference in substituting a for-profit insurance company as the middle person?

The American Heath Care Act negotiations are illustrative. With control of both the House and the Senate and the White House, Republicans have looked impotent in passing a replacement law. Why?

Well, it turns out that Americans overall have found Obamacare a step forward versus what preceded it. As the debate has unfolded. Americans are learning that Republicans are more intent on sharply reducing Medicaid both as an adjunct to Obamacare and as a stand alone program. It is beginning to dawn on Americans that Medicaid is very important program paying for about half of all births.  I wonder why so many Americans cannot afford healthcare insurance with pregnancy benefits? Medicaid is also critical to treating the Opioid crisis and for nursing home assistance for the elderly. And yet the Republicans are pressing on. Why?

Could it be the GOP is single-mindedly focused upon tax cuts?

Replacing Obamacare comes with a $200 million tax cut for the wealthy. The Trump/GOP’s tax reform (code for tax cuts), a separate piece of legislation, will represent billions in savings for the wealthy. Hmmm.

Back to the current Senate AHCA debate. Most Senators are aware that cuts to benefits (like eliminating pre-existing condition coverage) are very unpopular with constituents. They are now learning that critical health services are tied to Medicaid coverage. So, if AHCA keeps most or all of ACA benefits and ends the individual mandate while eliminating the associated taxes, the AHCA will cost the government more than ACA now does. Hmmm.

At this hour, the Washington soap opera is still underway. There are more than enough “no” votes to preclude Senate passage of AHCA 1.5. No matter how many times President Trump tweets that “it’s a great plan”, “people will love it”, or “AHCA is another campaign pledge kept”, certain facts remain.

Any ACA replacement which includes tax breaks for the wealthy will by budget necessity, also bring Americans less benefits at higher costs and fewer insured. Hmmm.

I guess if you number one priority is tax cuts for wealthy individuals and corporations, healthcare doesn’t really matter.