Old business: Point to Conan, he couldn't have been clearer. I despise Noonan for her Enron chicanery, but she served Reagan brilliantly.

It almost certainly wasn't hers, as the man had his own fine ear for humor, but I'd not heard this one until today.

Obama finally finds his voice again.

I get that Obamacare has wrecked health care for a lot of people, including our esteemed hostess.

But it's also made it accessible for those who previously didn't have it.

Is my life and livelihood dependent on this? Nope. I've got the VA if all else fails.

Queue the doomsayers, "You may not have it for long!"

You've been saying that for literally decades. It's still there.

The point being is this: Did Trump promise a replacement for Obamacare, that it was going to be brilliant, etc.? Yes, he did.

Did he attempt to repeal Obamacare without a single shred of its "brilliant" replacement in place? Yes, he did.

End of.

Ghosts

Patrick, having had to attempt to care for VA patients for years, I sincerely hope you never have to use them. It's an appalling dung heap, overflowing with the most disgraceful assortment of beaurocratic ineptitude imaginable, mangled up in tangled-up knots.

Yes Patric Obamacare did make healthcare more accessible for some. And it made it inaccessible for many others. On the balance it was not an improvement.

And yes Trump promised to replace Obamacare. A promise he failed to keep. A president isn't a dictator. At least they aren't supposed to be one. Trump didn't have the votes. Simple as that.

Let us not forget the awesome failure represented by the employer mandates in "Obamacare", itself a fountain of lies.

But don't just complain. Suggest a solution!

Or... sit and do nothing.

Patrick, having had to attempt to care for VA patients for years, I sincerely hope you never have to use them. It's an appalling dung heap, overflowing with the most disgraceful assortment of beaurocratic ineptitude imaginable, mangled up in tangled-up knots.

momof4 at October 22, 2020 6:43 AM

Depends where you are. The VA hospital where I live has a very good reputation. But this is a small city with not much poverty, or homelessness. It doesn’t attract a lot of indigents, nor does it seem to be an attractive dumping ground for medical workers who literally can’t get or keep other jobs.

Since we are talking medical stuff, I had read some time ago about how there wouldn't be a covid baby bump because everyone was getting vasectomies. So even if there were supply line disruptions for birth control pills (and some places there were) most were expected to just get cut instead.

Well, a few weeks ago I was chatting with a urologist and he is fully booked. Not with vasectomies per say, just booked in general. With all the covid restrictions roughly half of the urologists in Houston have gone out of business. (Or so he said. I don't have actual data.) And the guys who specialized in non-cancer stuff were the first to go under. So most of the vasectomy specialists are currently looking for other work. As bad as that sounds he has people trying to recruit him to move. Several places around the US have over a 3 month wait list for urology services.

I don't know how things are on the other side of the equation. I've seen lots of obstetrician offices are closed but I haven't chatted with any recently. Maybe we won't have a baby bump but instead a miscarriage bump? Who knows?

On the news sites this morning, Fox's front page has Biden Jr.'s biz partner acknowledging that yes, the kickbacks to Biden Sr. were absolutely real.

ABC, NBC, CBS, and NPR have no mention of it.

Odd.

Never fear Gog. Right thinking will be restored. Such misinformation will be removed.

Meh. This is why I told Conan good speeches don't matter anymore. No one listens after too many lies.

In 2018 the NY Times won the Pulitzer prize for "deeply sourced, relentlessly reported coverage in the public interest that dramatically furthered the nation’s understanding of Russian interference in the 2016 presidential election and its connections to the Trump campaign, the President-elect’s transition team and his eventual administration." All of which never happened. More recently they won one for their 1916 project. Another transparent fabrication.

The Pulitzer is hardly the only award so devalued. Sad Puppies was about the Hugo being awarded for the color of the author's skin instead of the quality of their work. New York Times 'Best Sellers' list has also won acclaim for how long it has been fake. Twitter and Facebook haven't been that skillful with their attempts at censorship and electioneering. And I haven't even covered politics!

Like the boy who called wolf, lie too many times and no one listens anymore.

The VA in my area, Bay Pines, also enjoys a decent reputation. But of course, it doesn't have to stay that way.

Yes, Ben, I get that Obamacare was great for some, a catastrophe for others.

But the point I was making is that Trump said he would replace it. He attempted to repeal without a replacement waiting in the wings. Perhaps that's why McCain said no.

But the point I was making is that Trump said he would replace it. ~ Patrick at October 22, 2020 2:47 PM

And yes Trump promised to replace Obamacare. A promise he failed to keep. ~ Ben at October 22, 2020 6:44 AM

Why are people looking for yet another hugely expensive and overly bureaucratic government program to replace Obamacare, a hugely expensive and overly bureaucratic government program.

Using insurance companies as middlemen in the provision of healthcare has driven costs up - adding another layer to that model will only make the costs rise and the service delivery worse.

Joe Biden promises to keep Obamacare intact, expand it, and pay for it without raising taxes on the majority of Americans. And without cutting any other social programs.

Donald Trump promises to replace Obamacare with some new program that will be "yoogely" better, but can't articulate even a single guiding principle that would underly his replacement.

Now, I recognize that healthcare delivery is not like retail. One does not comparison shop for emergency rooms and many medical conditions don't have one-and-done cures. Nonetheless, we should still be able create a pay-as-you-go model that won't break the bank and doesn't require intervention and oversight by insurance bureaucracies adding extra layers and driving up costs.

We have state insurance regulators with different requirements for each state, limiting the portability of coverages. We have tied insurance to employment, again limiting portability. Obamacare forces everyone to buy an expensive comprehensive program. Why would anyone think letting the government develop and manage a healthcare delivery would lower costs and improve service?

> Why would anyone think letting
> the government develop and manage
> a healthcare delivery would
> lower costs and improve service?

Well, in the High School America scheme of public identity, the guy on the street thinks of "lower costs" as 'less out-of-pocket for myself.' (Remember Amy's visitor "brian"? The doctor, he said, would "eventually get his money.")

We can blame the present atrocities on the AMA, the schools, the employers, the insurance business, and ever level of government without wasting any firepower.

But the greatest source of evil at work here is the idea that people have a right to health care.

American health care, from the best down to the better-than-average, is probably the finest blessing ever given to human life… The brightest, most talented people of the highest integrity making enormous sacrifices and investments in the well-being of others.

Those people expect to be paid and paid well. That's okay by me! I want the best. I'll pay for the best I can afford. I have no 'right' to their effort on my behalf.

Health care costs so much because it's so good. People should be ready to pay for it… Beyond that, most everything is chatter and gamesmanship.

But the greatest source of evil at work here is the idea that people have a right to health care. ... I have no 'right' to their effort on my behalf. ~ Crid at October 22, 2020 7:19 PM

I've been saying for years that "right to healthcare" does not exist; that such a "right" implies one is entitled to the training, expertise, and skills of the medical professional, to the fruits of someone's labor, without compensating the provider.

Any "right" that obligates another on my behalf is not a universal right. My right to free assembly does not obligate anyone to provide the meeting place. My right to free speech does not obligate anyone to provide the microphone. My "right to healthcare" obligates the person with medical knowledge, the provider of the medical equipment, and everyone in the supply chain to work on my behalf without any promise of compensation for their efforts. That's the essence of serfdom.

I noticed that, in the debate last night, Joe Biden spoke of a "right to access to healthcare," not a right to the healthcare itself, as has been a Democrat talking point for years, the underpinning assumption of Obamacare. Simple wording change or fundamental change in attitude? We'll see.

"I noticed that, in the debate last night, Joe Biden spoke of a "right to access to healthcare," not a right to the healthcare itself, as has been a Democrat talking point for years, the underpinning assumption of Obamacare. Simple wording change or fundamental change in attitude? "

Neither. It's a dodge. That way, when public policy has killed the medical profession, suffocating it under the mountain of flesh represented by bureaucracies paid 24/7, he and his supporters can claim what I have noted already whilst wrapping themselves in virtue:
"You're sick? The clerk is not sick. Fill out this form. Is the form filled out? Then the system is working perfectly. You're not being denied treatment - it's just not available right now."

Because access is not treatment. A point fully covered in my link above.

Patrick, the only real improvement is deregulation. The only 'brilliant' solution is repealing both federal and state regulations with nothing to replace them. This is a problem government can't solve.

As for McCain, no that is not why he voted no on the repeal. He was quite clear why he did so. McCain hated Trump. A two bit TV guy got to be president and McCain didn't. Really as simple as that. A very disappointing but also very human response to things.

And perhaps I wasn't clear in my response. If this issue causes you to not vote for Trump then I support you. It is a valid complaint. I don't share your views. But I can respect them.

Well, in the High School America scheme of public identity.... ~ Crid at October 22, 2020 7:19 PM

When I lived in North Florida, a friend of mine who'd moved there for college remarked that the first question anyone asked him was "where did you go to high school?" That was how they identified you, categorized you, and understood you.

The article mentions Lori Lightfoot, mayor of Chicago, being remarkable because she's the first modern mayor who did not go to high school in Chicago. Her status as an outsider is not due to her race or sexual orientation, but to her lack of high school credentials from the city.

Ben Johnson's "speak that I may see thee" has become "tell me your high school that I may know thee." Lisa Birnbach's The Official Preppy Handbook declared the quintessential preppy greeting as "where did you prep?" Your high school identity being how they knew what to make of you; St. Mark's, Exeter, or Andover being your branded identity for life, not Harvard or Yale.

Even the UK puts more emphasis on secondary schooling as a social marker than it does college. While Oxford and Cambridge dominate the college discussions, the top rungs of the social ladder put more emphasis on whether you were educated at Eton or Rugby than where you went to college.

We live in a high school world.

But it's also made it accessible for those who previously didn't have it.

Uh huh
If the ACA was so great why did congress rush to exempt themselves

Why did the SCOTUS have to rule it a tax?

It strongly depends on who you are Lujlp.

The very vast majority (something like 90%) of the people who 'gained access to healthcare' already had it. There were a significant number of people who already qualified for medicaid but hadn't bothered to enroll. Now many of them are enrolled. Which oddly enough appears to be the cause of the lower average lifespan in the US recently.

As for those who actually pay for insurance it depends on how old you are. People over 50 saw significant cuts in how much they paid. And hence you saw a significant increase in enrollment. But money doesn't just come from nowhere. People under 30 saw huge increases in what they had to pay. And hence you saw significant decreases in their enrollment. Needing to spend a minimum of $20k before getting any benefit made insurance worthless to that population segment. That is 40% of the median household income after all.

And hence the obamacare death spiral. The more young people dropped out the higher the price on those young people still enrolled and the less sense it made to stay enrolled. And that doesn't even touch the access to doctor issues with obamacare which are also age biased.