# House passes "repeal and replace" **URL:** \ **Category:** Great Debates\ **Created:** [May 4, 2017, 8:53pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871 "2017-05-04T20:53:38Z")\ **Posts on this page:** 20\ **Page:** 23
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [May 6, 2017, 3:52am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/441 "2017-05-06T03:52:07Z")
> [@Shagnasty](#): > > I am fine with helping the lower 10 percent or so help get some form of health insurance but I am not willing to let the mechanism that enables that effectively disable my own. I have no idea why many people are so ideologically tied to ObamaCare. It started out as a Republican idea after all and has only been with us for a few years and has obviously failed miserably by almost every measure except for a small group of poor people that now have greatly subsidized health insurance at the expense of everyone else. That is not a good metric unless you are an illogical bleeding-heart. We can do much better. What the Republicans just passed was worse. Incidentally, not even Romney care in Massachusetts was set to control costs much like Obamacare, and yet: > **['RomneyCare' Facts and Falsehoods - FactCheck.org](https://www.factcheck.org/2011/03/romneycare-facts-and-falsehoods/)** > > It has been nearly five years since Massachusetts Gov. Mitt Romney signed the state's landmark health care law amid the political flourish of a fife and drum corps and 300 guests in Boston’s Faneuil Hall. The overhaul is largely seen as a blueprint... > [@](#): > > Among practicing physicians, 70 percent supported the law in a fall 2009 survey, also from Harvard. That poll, published in the New England Journal of Medicine, also found that 60 percent of physicians said the law didn’t have much of an impact on how long patients wait to get an appointment (and 2 percent said there was a positive impact). Eighty-five percent said the law either had not much impact or a positive impact on the quality of care patients receive. > > Bills haven’t been filed to repeal the individual mandate, says Rosman with Health Care for All. And there was no taxpayer revolt when the state asked residents to confirm their insurance status on their tax returns. “We were totally expecting a big issue,” particularly from libertarians, he says. “I expected people to write on their tax return, ‘Go to hell.’ ” Instead, more than 98 percent of tax filers complied. As noted before, this was a chance to do better indeed, but the Republicans decided to do it worse. > **[This chart shows why the GOP health plan will make health insurance more...](https://www.businessinsider.com/ahca-premiums-rise-trumpcare-2017-3)** > > The CBO found the AHCA would make premiums 10% lower by 2026 than under current law. But that's because plans will be skimpier and customers will be younger. > [@](#): > > One of the few numbers from the Congressional Budget Office analysis of their healthcare plan that Republicans have been eager to trumpet is this: Under their plan, individual market health-insurance premiums will be 10% lower on average than they would be under Obamacare by 2026. > > This is a finding from the CBO report on the American Health Care Act, but it’s misleading. > > The more relevant fact for consumers is this: For a given customer, buying a plan that provides a given level of benefits, premiums are expected to be on average 13% higher under the AHCA than under Obamacare, using the CBO’s assumptions about premiums overall. > > That’s according to a new analysis from Brookings Institution scholars Matt Fielder and Loren Adler. > > How can it be true that premiums would go down overall but up for a given plan for a typical person? It’s because the AHCA will change the health insurance market so the average person buying a plan in the individual market is younger, and is buying a stingier plan. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 6, 2017, 3:58am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/442 "2017-05-06T03:58:34Z")
This argument cannot be won by simply declaring your opponents are immoral, cruel, or sociopathic. Those are examples of poisoning the well, ad hominem attacks that do nothing to show the merits of your arguments. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [May 6, 2017, 3:59am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/443 "2017-05-06T03:59:49Z")
There’s a lot more than that to Obamacare – for instance, the ban on pre-existing conditions and mandating minimum medical payouts as a percentage of revenues. But you’re partly right in the sense that insurers inevitably turned this to their advantage by raising rates to deal with the former and willingly paying outrageous fees (offset by higher premiums) to deal with the latter, because after all 15% of a large amount is better than 15% of a smaller amount. The whole corrupt industry stinks to high heaven, and the hope was that the ACA would at least expand coverage (it did) and pave the way for an eventual public option and the kind of regulation that exists everywhere else in the world. It didn’t do that, and instead of pushing for that kind of reform, now the neanderthals are taking it all in exactly the wrong direction, simply using it as a pretext for more tax cuts for the rich and abandoning what little had been accomplished, leaving millions uninsured again. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [May 6, 2017, 4:03am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/444 "2017-05-06T04:03:23Z")
> [@Bricker](#): > > This argument cannot be won by simply declaring your opponents are immoral, cruel, or sociopathic. Those are examples of poisoning the well, ad hominem attacks that do nothing to show the merits of your arguments. Meh, as per the mod note, the issue was indeed that one should not had pushed against a poster, but the reality is that the evidence shows that the Republican leadership and powerful interests are the ones that are immoral and cruel and are misleading many. As Romney showed, that was not the case until recently. And besides there is already a lot of evidence presented that has nothing to do about morality, even the bottom line shows that most developed nations on earth do cover all of their citizens and with less cost than the irrational system we got. ---
**Author:** ![octopus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/octopus/32/3716_2.png) [@octopus](https://boards.straightdope.com/u/octopus)\ **Post date:** [May 6, 2017, 4:15am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/445 "2017-05-06T04:15:02Z")
> [@Budget\_Player\_Cadet](#): > > Meanwhile, outside the realm of tiresome and tedious argumentations from tenthers and libertarians, this bill which you folks are celebrating will end up stripping tens of millions of Americans of their health care. Personally, when it comes to the question of this legislature, I think that’s a _slightly more crucial point_, don’t you? No. Because unconstrained power leads to things much worse than expensive healthcare. I’m surprised that thousands of years of history and current events aren’t sufficient evidence that one needs to be careful in how to allocate power. People rightfully fret over a deranged individual or movement that kills a few or a few hundred. But governments which have killed 10s of millions in the 20th century are not properly assessed. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [May 6, 2017, 4:15am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/446 "2017-05-06T04:15:06Z")
> [@GIGObuster](#): > > What the Republicans just passed was worse. Incidentally, not even Romney care in Massachusetts was set to control costs much like Obamacare, and yet: yes. By no means was Obamacare perfect. But it was better than this pile of shit. ---
**Author:** ![octopus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/octopus/32/3716_2.png) [@octopus](https://boards.straightdope.com/u/octopus)\ **Post date:** [May 6, 2017, 4:16am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/447 "2017-05-06T04:16:58Z")
> [@TimeWinder](#): > > Some weird-ass philosophical quirk about separation of powers is more necessary of the long term health of the nation than the lives of the people in it? > > That view is sociopathic. The victims of 20th century Germany, USSR, China, Cambodia might disagree. ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [May 6, 2017, 4:19am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/448 "2017-05-06T04:19:43Z")
> [@Bricker](#): > > This argument cannot be won by simply declaring your opponents are immoral, cruel, or sociopathic. Those are examples of poisoning the well, ad hominem attacks that do nothing to show the merits of your arguments. …the argument can’t be won by simply characterising the opposing position as “unwise.” ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [May 6, 2017, 4:43am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/449 "2017-05-06T04:43:43Z")
> [@octopus](#): > > The victims of 20th century Germany, USSR, China, Cambodia might disagree. “I’m sorry, if we save your son’s life, we’ll start an inevitable slide into tyranny. We appreciate your sacrifice.” ---
**Author:** ![octopus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/octopus/32/3716_2.png) [@octopus](https://boards.straightdope.com/u/octopus)\ **Post date:** [May 6, 2017, 5:00am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/450 "2017-05-06T05:00:06Z")
> [@Leaper](#): > > “I’m sorry, if we save your son’s life, we’ll start an inevitable slide into tyranny. We appreciate your sacrifice.” Inevitable? That’s silly. Tell me this, how’d you like Trump or Pence or Nixon with 0 constraints? And if you’d like them, or worse, constrained tell me how’d you structure such a system. Bricker rightfully appreciates history. The beauty of the American constitution is that it has a process for peaceful self-modification. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [May 6, 2017, 5:27am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/451 "2017-05-06T05:27:25Z")
> [@octopus](#): > > Bricker rightfully appreciates history. The beauty of the American constitution is that it has a process for peaceful self-modification. Tell me about it. The last time the Republicans elected a guy with little government experience, that got into trade wars that affected the economy, and [used the law to enforce morality](http://history.house.gov/Historical-Highlights/1901-1950/The-Volstead-Act/); it lead to an almost total collapse of the party. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [May 6, 2017, 5:32am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/452 "2017-05-06T05:32:47Z")
> [@Bricker](#): > > The continued erosion of any understanding that there is even a difference between federal and state power. And this is bad because… ---
**Author:** ![octopus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/octopus/32/3716_2.png) [@octopus](https://boards.straightdope.com/u/octopus)\ **Post date:** [May 6, 2017, 5:47am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/453 "2017-05-06T05:47:01Z")
> [@Miller](#): > > And this is bad because… Do the fundamental aspects of a government have relevance? ---
**Author:** ![The\_Tooth](https://avatars.discourse-cdn.com/v4/letter/t/c67d28/32.png) [@The\_Tooth](https://boards.straightdope.com/u/The_Tooth)\ **Post date:** [May 6, 2017, 6:45am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/454 "2017-05-06T06:45:38Z")
> [@Bricker](#): > > I don’t know either. > > But since I haven’t claimed that there was a substantial difference between health insurance laws written by a state legislature and those written federally, I’m not discomfited at not knowing. Then allow me to fight your ignorance; there is no substantial difference. Therefore it’s okay for the Federal government to write health insurance laws. If there’s no substantial difference between two outcomes arrived at through different means, then it’s fine for either means to be employed. According to you, anyway. Or does that argument only apply when you’re making excuses for Republicans who refuse to do their jobs out of pique? ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [May 6, 2017, 7:10am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/455 "2017-05-06T07:10:45Z")
> [@octopus](#): > > Inevitable? That’s silly. Tell me this, how’d you like Trump or Pence or Nixon with 0 constraints? > > And if you’d like them, or worse, constrained tell me how’d you structure such a system. > > Bricker rightfully appreciates history. The beauty of the American constitution is that it has a process for peaceful self-modification. My point, as it has been all along, is that you’ll never make any headway while people on the opposite side are hearing my quote you’re responding to in what you say (and they do). If conservatives, especially those in government, want to persuade others that they’re not evil, they’ll have to do a lot more to also introduce reasonable and reasonably immediate solutions to their plights, assuming you care (and you should, if only for politics’ sake). You are not going to win converts or calm anyone with “sorry, the laws say you gotta go bankrupt paying your medical bills” and a shrug and amble off into the sunset, EVEN IF you think they deserve to be in their situation. ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [May 6, 2017, 10:59am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/456 "2017-05-06T10:59:03Z")
> [@Bricker](#): > > Too facile an analysis. People will suffer and die in car wrecks. But we permit the deadly contraptions to keep running. Are we monsters? Or do we engage in cold-blooded cost benefit calculations? What do you say to poor little Cindy Lou (who was no more than two) when her mommy was killed in a car crash that we could have stopped by requiring only professional drivers drive on our streets with public transportation vehicles and end the deadly scourge of private automobiles? Wow, that last bit is quite the straw man. It’s true that we can eliminate automobile fatalities altogether only by the most extreme means. But the same is true about preventable fatalities from health-related causes. So what? The fact is that we became a car-dependent society nearly a lifetime ago. There are two things we can do about that: one is to make cars safer, and the other is to make us less car-dependent. Should I mention which party has consistently worked to further both of these ends, and which one has consistently fought against it? When I graduated from high school, forty-five years ago, I was four times more likely than now to die in a car crash. (And this had nothing to do with being a teenage driver; I hadn’t gotten my license yet.) That’s right, an American is one-fourth as likely to be killed by automobile in 2017 as in 1972. We’ve pushed for seat belts, then shoulder harnesses, then standards for cars to absorb the shock of collisions, then air bags…and in all of these cases, the push for these things has come from the political left, and the resistance has come from the political right. And the push for public transit within and between urban areas has also come from the left, and resistance has come from the right. When President Obama included funds for high-speed intercity rail in the 2009 stimulus bill, who was it who blocked specific routes? Republican governors, even the comparatively sane ones like John Kasich. And supposedly sane conservative commentators like George F. Will [said things like](https://krugman.blogs.nytimes.com/2011/03/01/dagny-taggart-wept/): > [@](#): > > the real reason for progressives’ passion for trains is their goal of diminishing Americans’ individualism in order to make them more amenable to collectivism. So yes, Republicans and conservatives are moral monsters for continually fighting to keep Americans dying prematurely by automobile and by illness. While liberals and Dems (usually timidly in the latter case, but still) work to keep Americans **from** dying prematurely by automobile and by illness. We libruls are also considerably less keen on unnecessary wars, like the one in Iraq, than conservatives are. When it comes to people who have already been born, there is one pro-life party, the Democrats, and one pro-death party, the GOP. ---
**Author:** ![Bryan\_Ekers](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bryan_ekers/32/183_2.png) [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)\ **Post date:** [May 6, 2017, 11:01am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/457 "2017-05-06T11:01:45Z")
> [@RickJay](#): > > Speaking as a Canadian, a side effect of the ongoing American health care fiasco is that it makes it much harder to improve our system. Allow me to explain; the Canadian system (again, it varies from province to province but national funding laws make them close enough to forget about that for now) is pretty good. However, it’s not perfect, and has some systemic issues, and the costs are getting dizzying. > > The thing is, when it comes to health care, Canadians are the most conservative people in the world in the true sense of that word, because they want no basic element of the system to change - because with the U.S. media being such a behemoth in the discourse, many Canadians have exactly the same misapprehension; they think the Canadian way and the American way are the only possible ways it can be done, and that all other little countries in Europe do it the way we do, when in fact they almost universally don’t. IF you suggest any sort of private insurance scheme in basic medical services it’s “oh no that’s the American thing” though in fact it’s also how it’s done in France, Germany and Italy, which have systems we could really learn a thing or two from. I have to admit, I don’t understand the objection to the development of a “two-tier” system in Canada, where (roughly) everyone gets single-payer coverage but individuals who can afford it can purchase more elaborate insurance plans to cover treatments not generally available in Canada or get faster service from doctors who decide to deal primarily with these more-insured patients, etc. It’s always gong to be the case that money can buy you better stuff, but as long as a good level of basic stuff is available to all, I can’t feel compelled to object. There are risks, of course, of doctors abandoning the single-payer system entirely because they can earn more money in “concierge care”, but that’s already happening to some extent with doctors deciding to move the U.S., on the belief they can earn more money and pay lower taxes there. A two-tier system of some kind lets doctors earn more money and encourages them to stay in Canada. ---
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [May 6, 2017, 11:44am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/458 "2017-05-06T11:44:48Z")
Two tier systems where money buys better access is NOT what Canadians want. It has been repeatedly offered and attempted to get snuck in, but the populations has repeatedly and resoundingly refused it. Because it does not reflect our values. Though a small minority will continue to harp upon it, it won’t happen any time soon. There is good reason to fear that any attempt to shift it WILL lead to what US has. And we’ve all been watching that shit show for too many years to buy in to the propoganda. Proponents are usually backed by ‘for profit big medicine’ interests from US just itching to start profiteering from a new source. Nope. We’re not going down that road, thanks anyway! It’s curious though that a ‘so called’ Christian would openly and shamelessly value division of power politics over helping the poor and sick. Wondering where it says that in your Bible. ---
**Author:** ![Ramira](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ramira/32/344_2.png) [@Ramira](https://boards.straightdope.com/u/Ramira)\ **Post date:** [May 6, 2017, 12:01pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/459 "2017-05-06T12:01:13Z")
> [@Bricker](#): > > I don’t agree. The view is not remotely “weird-ass.” From my perspective, your view is the result of years of living without any emphasis being placed on the distinction between federal and state roles, so that anyone who insists on it is like an alchemist approaching Dow Chemical and asking if they have need of his Art. > > But your lack of exposure to, or contemplation of, the proper federal role does not erase it. Indeed, it just illustrates how desperately this stand is needed. This seems only to be an ad hominem without providing any supporting logic or justification, it is only ideology… There are many successful democratic federal systems in the OECD with the reserved powers to the local states, but that have realized the economic efficiency of some actions are achieved at the federal level. Erecting as a not reflectable division is the realm of the irrational ideology. I would expect the anglosaxon pragmatism… > [@Bricker](#): > > The consequences that concern me are rooted in vitiating federalism, not in healthcare outcomes. So you are placing an ideological theory unexaminable over the pragmatic compromising approach to find the economically efficient resolution to your national challenge in the objectively very poor performance of the health in the United state which has you spending much more than any other developed country in the percent of the GDP, but having the national population health indicators of a middle income country. This accumlating bad health performance in the cost and in the bad overall health results has the impact on the economic growth… I find this anti-pragmatism, ideological, very surprising, it is very unanglosaxon. > [@Bricker](#): > > Federalism and the constitution are political ideologies, and important ones. Putting idealized political ideology, frozen without open to the pragmatic examination is I think against the anglosaxon political history and something more like the ideological style of the marxist than the evolutiionary market pragmatism of the common law anglosaxon tradition. It is bizarre. > [@octopus](#): > > The victims of 20th century Germany, USSR, China, Cambodia might disagree. This is of course a statement that is both completely bankrupt and completely without any historical the history of the stable democratic republics over the past century that have implemented for the national efficiency reasons the central public health insurance makes this strange statement completely bankrupt and extremely stupid, showing a very poor grasp of the history. > [@Bryan\_Ekers](#): > > I have to admit, I don’t understand the objection to the development of a “two-tier” system in Canada, where (roughly) everyone gets single-payer coverage but individuals who can afford it can purchase more elaborate insurance plans to cover treatments not generally available in Canada or get faster service from doctors who decide to deal primarily with these more-insured patients, etc. It’s always gong to be the case that money can buy you better stuff, but as long as a good level of basic stuff is available to all, I can’t feel compelled to object. … A two-tier system of some kind lets doctors earn more money and encourages them to stay in Canada. Is this different from the France, where there is the health insurance Mutuelles but one can buy the “complementary” insurance, although usually it is an employer providing the extra benefit over the base? ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 6, 2017, 12:37pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/460 "2017-05-06T12:37:53Z")
Let’s discuss this to see if it is even feasible for single states to do such a thing. Hypothetical: The state of California votes in UHC for all residents of that state. What happens next? [Previous page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=22) [Next page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=24)