Wednesday, March 22, 2017

Everybody Hates the New Republican Replacement for ObamaCare; Thus, it Must Be Good Enough to Pass the House of Representatives Tomorrow

Everybody Hates the New Republican Health Care Plan; It Must Be Good The House of representatives is scheduled to vote on Phase I of the Republican plan to repeal and replace Obamacare. The assumption is that there would not be a vote unless the Speak of the House, the Majority leader, and the Whip knew they had the votes. Seemingly everyone is opposed to the Republican plan. Thus, it must be good. One of the jokes about a good compromise is that both sides are unhappy. This is a list of those lining up against The American Healthcare Act:” AARP The American Hospital Association Federation of American Hospitals America’s Essential Hospitals American Medical Association American Nurses Association National Nurses United American Academy of Family Physicians American College of Physicians American Public Health association National Physicians United Association of American Physicians and Surgeons National Disability Rights Association Families USA AFL-CIO AFSCME National Council of La Raza Club for Growth Freedom Works Heritage Action for America Americans for Prosperity The Koch Brothers Presumably every Democrat in Congress. The Freedom Caucus of conservative House Republicans. So much Sturm und Drang. The media is proclaiming the Republicans lack the votes in the House and that it would be DOA at the Senate. Maybe, but if the Republicans have a secret plan to pass the Bill as they really want. First, they should pass it by one vote in the House and send it to the Senate. The Senate in turn will may several amendments to the bill, substantially changing he House bill. It would then go to a conference committee, the differences will be ironed out, and the final bill will placate the conservatives. Conservative critics are correct. The House bill is not a total repeal. Nor can it be! ObamaCare is a disaster, unraveling before our eyes. It is sinking almost as fast as Sears. The republican Congress will never bail out Obamacare in its present form. Yet, they cannot let it die on their watch. They will be pilloried if they kill it without a satisfactory replacement. The American medical system was cracking eight years ago. ObamaCare broke it, shattering it into pieces. Repealing Obamacare without any replacement will not, and cannot, put the pieces back together again. Killing the entitlement of ObamaCare will destroy the Republican electorate in at least the short term. Several provisions of ObamaCare are basically untouchable: 1 Keeping children on parents’ policies through age 26; 2 Eliminating the pre-existing condition clause; and 3 Eliminating the cap on benefits. The pre-existing conditions coverage and the end of the cap are what drive up the cost of ObamaCare, which tried to cover these costs through a seemingly infinite number of taxes. It fails because it violates the basic economics principle of supply and demand. It radically increases demand, while freezing supply. Other constraints are not striping the Medicaid and ObamaCare recipients off the coverage rolls. Finally, repeal and replace lacks 60 votes in the Senate. Unless the Senate Republicans repeal the filibuster, they are constrained by the Senate rules of reconciliation. Hence, the dance of a partial repeal followed, theoretically, by two more rounds of legislation. The Republican bill lacks several cost savings measures, including malpractice and defensive medicine, driven by malpractice litigation. Nor does it offer insurance across state lines. The litigation reforms are actually in another measure going through Congress at this time. The proposal repeals most, but not all, of the ObamaCare tax increases. It delays, but does not end the Cadillac tax. It will turn Medicaid over to the states with block grants. It will result, with the help of Secretary of Health and Human Services Tom Price, much of the mandated coverage which drives up the costs of medical care. The reviled, and often ignored, individual mandate will become history. I still think the mandate is unconstitutional, but Chief Justice Roberts went through judicial conniptions to uphold it. The house should pass it. One final thought. Ignore the Congressional Budget Office (CBO). The CBO was in bed with the Obama Administration, working with the Democrats to massage the costs and taxes to make it look like an economic winner. In essence, the CBO helped cook the books on ObamaCare. Repeal, amend, conference committee, and replace ObamaCare.

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