# 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:** 56
**Author:** ![HurricaneDitka](https://avatars.discourse-cdn.com/v4/letter/h/96bed5/32.png) [@HurricaneDitka](https://boards.straightdope.com/u/HurricaneDitka)\ **Post date:** [June 28, 2017, 12:07am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1101 "2017-06-28T00:07:09Z")
In your last couple of posts you’ve compared a lower growth rate in Medicaid spending to “Conspiring to kill off the poor residents of the state” and “taking away your ability to live”. I don’t think I know how to properly express to you how wildly _unhinged_ that sounds to me. ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [June 28, 2017, 12:12am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1102 "2017-06-28T00:12:27Z")
> [@Lemur866](#): > > Seriously? > > You thought Obamacare was going to implement an insurance freeze, and that insurance companies were going to be required to offer you the exact same policy for the exact same price for the rest of your life? > > You didn’t think that, did you? > > Or is it more reasonable that it meant “We’re not abolishing private insurance and making everyone get government insurance”? My response was always “No one ever said your plan had to keep YOU.” And I always point out that many of these plans that were eliminated didn’t even qualify as insurance under the old laws. They were called health club plans or health saving plans or something that didn’t use the word insurance. Because they couldnt legally call themselves insurance. There was a notoriously bad class of plans that actually covered a lot with very low copays but the catch was they generally had a 2K a year maximum benefit. But people that didn’t have anything serious happen to them loved it, it was cheap and covered eyeglasses and routine doctor visits. But it wasn’t “insurance” in any real sense, it didn’t offer any protection against catastrophe. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [June 28, 2017, 12:12am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1103 "2017-06-28T00:12:42Z")
> [@](#): > > In your last couple of posts you’ve compared a lower growth rate in Medicaid spending to “Conspiring to kill off the poor residents of the state” and “taking away your ability to live”. I don’t think I know how to properly express to you how wildly unhinged that sounds to me. Oh, OK, see the problem! Nobody told you that the method for reducing Medicare growth involved kicking people off of it! Somebody should have, our bad! ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [June 28, 2017, 12:17am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1104 "2017-06-28T00:17:36Z")
> [@HurricaneDitka](#): > > In your last couple of posts you’ve compared a lower growth rate in Medicaid spending to “Conspiring to kill off the poor residents of the state” and “taking away your ability to live”. I don’t think I know how to properly express to you how wildly _unhinged_ that sounds to me. I believe you’ve been handed studies and analyses of the anticipated effects of this legislation. If you choose not to believe them, possibly due to having much better personal information and/or a time machine that allows you to see the future impact directly, then you have good reason to deny these studies and analyses. But since we mere mortals don’t have access to such information, we have no reason whatsoever to dismiss the claims that there will be people who find their availability to health care reduced, and that some of those people will either die directly or suffer an increased financial burden that reduces their ability to support themselves in their lives. And if you do _not_ have additional secret information, then, well, you used the word “unhinged”. I think it’s reasonable to hand it back to you. ---
**Author:** ![Fiveyearlurker](https://avatars.discourse-cdn.com/v4/letter/f/da6949/32.png) [@Fiveyearlurker](https://boards.straightdope.com/u/Fiveyearlurker)\ **Post date:** [June 28, 2017, 12:22am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1105 "2017-06-28T00:22:58Z")
Stirring support by the [president](https://www.vox.com/policy-and-politics/2017/6/27/15882238/trump-senate-health-bill): “This will be great if we get it done. And if we don’t get it done, it’s just going to be something that we’re not going to like. And that’s okay, and I understand that very well.” ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [June 28, 2017, 12:33am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1106 "2017-06-28T00:33:21Z")
> [@Ravenman](#): > > Again, aside from the frankly stupid matter of whether a word choice is the most accurate Are you calling me stupid? ---
**Author:** ![HurricaneDitka](https://avatars.discourse-cdn.com/v4/letter/h/96bed5/32.png) [@HurricaneDitka](https://boards.straightdope.com/u/HurricaneDitka)\ **Post date:** [June 28, 2017, 12:34am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1107 "2017-06-28T00:34:15Z")
> [@begbert2](#): > > I believe you’ve been handed studies and analyses of the anticipated effects of this legislation. I don’t believe I have, but I’ve been busy in lots of threads, so if someone has given me a link to something, I apparently missed it. Let’s deal with your histrionics about death directly though, for a moment, if you don’t mind. The chief concern seems to be something along the lines of ‘the AHCA / BCRA is going to _literally_ kill people’. OK. You said “some” people in your last post. Do you have any idea how many? Is it a significant number? Are there some 'studies and analyses of the anticipated effects" in that particular area (deaths)? I asked a page or two ago and didn’t see an answer. Not to be too crass about it, but something like 2.6 million Americans died in 2014. In 2015, it was probably pretty similar. Same for 2016, and, here’s a wild guess: 2017 will probably look similar. Do you expect that the passage of the AHCA / BCRA will significantly alter [these figures](https://www.cdc.gov/nchs/products/vsrr/mortality-dashboard.htm) for future years? Did Obamacare significantly alter them? ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 28, 2017, 12:41am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1108 "2017-06-28T00:41:13Z")
> [@D\_Anconia](#): > > Are you calling me stupid? Absolutely not. I’m saying that it is a first-rate silly argument to go on and on about the perceived differences between “causing the death of” and “killed by.” It is an argument that is beyond silly, and the only words I can apply to the merits of such discourse are harshly critical. ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [June 28, 2017, 12:46am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1109 "2017-06-28T00:46:18Z")
> [@HurricaneDitka](#): > > In your last couple of posts you’ve compared a lower growth rate in Medicaid spending to “Conspiring to kill off the poor residents of the state” and “taking away your ability to live”. I don’t think I know how to properly express to you how wildly _unhinged_ that sounds to me. Agreed, 100%. ---
**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:** [June 28, 2017, 12:46am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1110 "2017-06-28T00:46:26Z")
> [@Lemur866](#): > > Republicans have quit holding town halls, because they’re tired of listening to people worried that they’re going to lose their health care. > > [Republicans don't hold town halls anymore - Vox](https://www.vox.com/policy-and-politics/2017/6/27/15880904/republicans-town-hall-health-care) How pathetic and craven, this new government of the people Trump has given back. ---
**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\ **Post date:** [June 28, 2017, 1:03am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1111 "2017-06-28T01:03:36Z")
If trying to pass it quickly before people find out what’s in it doesn’t work, whatever you do, hide from the people you represent. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [June 28, 2017, 1:22am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1112 "2017-06-28T01:22:09Z")
Taking healthcare away from people is murdering them. It’s just doing so with additional cover. If life is a right, then healthcare, which is vital to sustain life, must also be a right. Any policy that results in people dying due to lack of money is morally repugnant. It’s actually one of the issues I put forth to the Christian Right. How in the world is letting poorer people die Christian? Then again, they are the ones who scream “personal responsibility” when Jesus said the exact opposite. ---
**Author:** ![Sunny\_Daze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunny_daze/32/438_2.png) [@Sunny\_Daze](https://boards.straightdope.com/u/Sunny_Daze)\ **Post date:** [June 28, 2017, 1:46am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1113 "2017-06-28T01:46:55Z")
> [@HurricaneDitka](#): > > I don’t believe I have, but I’ve been busy in lots of threads, so if someone has given me a link to something, I apparently missed it. Let’s deal with your histrionics about death directly though, for a moment, if you don’t mind. > > The chief concern seems to be something along the lines of ‘the AHCA / BCRA is going to _literally_ kill people’. OK. You said “some” people in your last post. Do you have any idea how many? Is it a significant number? Are there some 'studies and analyses of the anticipated effects" in that particular area (deaths)? I asked a page or two ago and didn’t see an answer. > > Not to be too crass about it, but something like 2.6 million Americans died in 2014. In 2015, it was probably pretty similar. Same for 2016, and, here’s a wild guess: 2017 will probably look similar. Do you expect that the passage of the AHCA / BCRA will significantly alter [these figures](https://www.cdc.gov/nchs/products/vsrr/mortality-dashboard.htm) for future years? Did Obamacare significantly alter them? Taking a quick look for data online finds the following: > [@](#): > > The story is in the data: The biggest and most definitive study of what happens to death rates when Medicaid coverage is expanded, published in the New England Journal of Medicine, found that for every 455 people who gained coverage across several states, one life was saved per year. Applying that figure to even a conservative estimate of 20 million losing coverage in the event of an ACA repeal yields an estimate of **43,956 deaths annually**. [Cite: Chicago Tribune](http://www.chicagotribune.com/news/opinion/commentary/ct-obamacare-repeal-lose-health-insurance-deaths-20170123-story.html) ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [June 28, 2017, 1:56am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1114 "2017-06-28T01:56:19Z")
> [@BigT](#): > > Taking healthcare away from people is murdering them. Exaggerate much? ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 28, 2017, 2:09am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1115 "2017-06-28T02:09:59Z")
> [@Sunny\_Daze](#): > > Taking a quick look for data online finds the following: > > [Cite: Chicago Tribune](http://www.chicagotribune.com/news/opinion/commentary/ct-obamacare-repeal-lose-health-insurance-deaths-20170123-story.html) Sure, you have the New England Journal of Medicine on your side, but did those medical experts take fifteen seconds to type “US rate pre and post aca yay Trump” into the Google machine? I bet not. ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [June 28, 2017, 2:20am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1116 "2017-06-28T02:20:07Z")
> [@D\_Anconia](#): > > Exaggerate much? No exaggeration at all, alas. Legislative murder, just as with the roll-back of environmental regulations leading to foul air and filthy water. People will die. ---
**Author:** ![HurricaneDitka](https://avatars.discourse-cdn.com/v4/letter/h/96bed5/32.png) [@HurricaneDitka](https://boards.straightdope.com/u/HurricaneDitka)\ **Post date:** [June 28, 2017, 2:56am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1117 "2017-06-28T02:56:44Z")
> [@Sunny\_Daze](#): > > Taking a quick look for data online finds the following: > > [Cite: Chicago Tribune](http://www.chicagotribune.com/news/opinion/commentary/ct-obamacare-repeal-lose-health-insurance-deaths-20170123-story.html) Thanks for the attempt at the answer. It got me pointed in an interesting direction. In January, [WaPo gave Sanders “Four Pinochios” for his claim that ‘36,000 people will die yearly’](https://www.washingtonpost.com/news/fact-checker/wp/2017/01/14/bernie-sanderss-claim-that-36000-people-will-die-yearly-if-obamacare-is-repealed/?utm_term=.3dba5c016f0a). His number came from an extrapolation of a couple of estimates by ThinkProgress. The one that seems relevant to your post is “that one person will die for every 830 people who lose their insurance.” That’s a bit different than the Oregon study’s 1/455 estimate. The 1/830 number came from “a study on the effect of the Massachusetts health-care law implemented by then Gov. Mitt Romney, not the Affordable Care Act. The study compared changes in mortality rates for adults from 2001-2005 to the rates in 2007-2010, after the law was implemented. The research indicated that for every 830 adults who gained insurance, there was one fewer death per year.” There are a whole raft of caveats that came with that number (that WaPo covers in the next couple of paragraphs). Basically, between that article, and [this one](https://www.washingtonpost.com/news/wonk/wp/2017/03/22/will-repealing-obamacare-really-kill-60000-people/), I think it’s fair to say that estimates are all over the map. ---
**Author:** ![Johnny\_Ace](https://avatars.discourse-cdn.com/v4/letter/j/6bbea6/32.png) [@Johnny\_Ace](https://boards.straightdope.com/u/Johnny_Ace)\ **Post date:** [June 28, 2017, 3:28am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1118 "2017-06-28T03:28:11Z")
> [@HurricaneDitka](#): > > Thanks for the attempt at the answer. It got me pointed in an interesting direction. In January, [WaPo gave Sanders “Four Pinochios” for his claim that ‘36,000 people will die yearly’](https://www.washingtonpost.com/news/fact-checker/wp/2017/01/14/bernie-sanderss-claim-that-36000-people-will-die-yearly-if-obamacare-is-repealed/?utm_term=.3dba5c016f0a). His number came from an extrapolation of a couple of estimates by ThinkProgress. The one that seems relevant to your post is “that one person will die for every 830 people who lose their insurance.” That’s a bit different than the Oregon study’s 1/455 estimate. The 1/830 number came from “a study on the effect of the Massachusetts health-care law implemented by then Gov. Mitt Romney, not the Affordable Care Act. The study compared changes in mortality rates for adults from 2001-2005 to the rates in 2007-2010, after the law was implemented. The research indicated that for every 830 adults who gained insurance, there was one fewer death per year.” There are a whole raft of caveats that came with that number (that WaPo covers in the next couple of paragraphs). Basically, between that article, and [this one](https://www.washingtonpost.com/news/wonk/wp/2017/03/22/will-repealing-obamacare-really-kill-60000-people/), I think it’s fair to say that estimates are all over the map. How many deaths are you alright with in exchange for your tax cut? What’s the minimum number at which you would say, “Alright, that’s too many?” How many lives driven into poverty by medical bills? ---
**Author:** ![HurricaneDitka](https://avatars.discourse-cdn.com/v4/letter/h/96bed5/32.png) [@HurricaneDitka](https://boards.straightdope.com/u/HurricaneDitka)\ **Post date:** [June 28, 2017, 3:51am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1119 "2017-06-28T03:51:56Z")
> [@Johnny\_Ace](#): > > How many deaths are you alright with in exchange for your tax cut? What’s the minimum number at which you would say, “Alright, that’s too many?” I don’t know, but something more than a rather speculative percent or two increase in annual deaths would probably make a more compelling story. As a society, we make all sorts of decisions that lead to tens of thousands of deaths a year. We allow people to buy Big Mac’s, drive cars, purchase alcohol, own guns, etc that cause / allow / contribute to roughly similar numbers of deaths. ---
**Author:** ![Sunny\_Daze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunny_daze/32/438_2.png) [@Sunny\_Daze](https://boards.straightdope.com/u/Sunny_Daze)\ **Post date:** [June 28, 2017, 4:28am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1120 "2017-06-28T04:28:32Z")
> [@HurricaneDitka](#): > > I don’t know, but something more than a rather speculative percent or two increase in annual deaths would probably make a more compelling story. As a society, we make all sorts of decisions that lead to tens of thousands of deaths a year. We allow people to buy Big Mac’s, drive cars, purchase alcohol, own guns, etc that cause / allow / contribute to roughly similar numbers of deaths. A 1-2% increase in annual deaths is non-trivial. It seems smaller when it’s framed as 1-2%. Looking at those handy [CDC numbers](https://www.cdc.gov/nchs/products/databriefs/db267.htm) (from 2015, seems to be the most recent), there are ~2,700,000 deaths a year in the US. 1% is 27,000. 2% is 54,000. I didn’t even get into the additional societal costs expected from the impacts to mental healthcare, drug addiction care, and elder care. Drug addiction costs alone are projected to increase in the billions. Medicare and Medicaid will no longer provide enough assistance to support the states in these areas. States and the families will get hit. Deaths from addiction are also predicted to increase, but I haven’t found a neat formula for that. I find your comparison of removing healthcare to allowing people to drive or own guns incomplete, but you are correct that this is a decision that we are making as a society. As a society, we want people to drive cars, eat hamburgers, and own guns. The data consistently shows at this point that as a society we are not in favor of the AHCA. We do want the key protections of the ACA to continue. If possible, we want them improved. [Previous page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=55) [Next page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=57)