# Trumpcare **URL:** \ **Category:** Politics & Elections\ **Created:** [March 7, 2017, 3:57pm UTC](https://boards.straightdope.com/t/trumpcare/781625 "2017-03-07T15:57:35Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [March 9, 2017, 12:11pm UTC](https://boards.straightdope.com/t/trumpcare/781625/81 "2017-03-09T12:11:34Z")
> [@adaher](#): > > If you’re referring to single payer, that’s not happening either. The general outline of ACA is our health care system now and will be for the next 100 years. All that’s left to be debated are the details. I believe you could describe the ACA as a step closer to the German system, which is not a bad one. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 9, 2017, 12:29pm UTC](https://boards.straightdope.com/t/trumpcare/781625/82 "2017-03-09T12:29:49Z")
> [@RTFirefly](#): > > 100 years is a long time. Imagine trying to predict today from the vantage point of March 9, 1917. > > Hell, right now, I’m not sure of my ability to prognosticate the next six months. Will the Republicans ultimately pass _something_ ACA-related that involves more than wonkish tweaks? Hell if I know, and so I don’t know whether it’ll undermine the ACA or the individual insurance market if it happens. Similarly, while I assume that if no new ACA-related laws are passed, Trump and Tom Price will do their damnedest to prove Obamacare is a failure by undermining it as much as possible through regulatory means, I don’t know the extent to which it will succeed. Prediction is hard, especially about the future. > > My WAG is that when the Dems are back in control of Congress, they’ll start lowering the Medicare eligibility age, to 60 fairly quickly, then gradually to 55. And over the course of the next few decades, the age will be successively lowered until it’s just Medicare, cradle to grave. Obviously, I’m resorting to hyperbole here, as advances could make the notion of needing to pay lots of money for health care obsolete. If you can print your own organ at home and have your robot that knows everything the human race knows put it in for you, then insurance isn’t really going to be a thing anymore. But as long as insurance is something people need, we’re sticking with multi-payer. The problem with the idea of lowering Medicare eligibility is that the trust fund is already near insolvency. What Congress could do is allow anyone to enroll in Medicare if they pay the full cost. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [March 9, 2017, 12:36pm UTC](https://boards.straightdope.com/t/trumpcare/781625/83 "2017-03-09T12:36:24Z")
As a brief aside, there was this little exchange on Twitter recently: > [@Charles C. W. Cooke](#): > > I’ve yet to read a single positive analysis of the House’s Obamacare bill. > [@other person on Twitter](#): > > try going 2 a conservative source? Open up your reading habits 2 include those w/ whom u would naturally dismiss > [@Charles C. W. Cooke](#): > > I’m the editor of National Review Online. Boom. ---
**Author:** ![NAF1138](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/naf1138/32/3245_2.png) [@NAF1138](https://boards.straightdope.com/u/NAF1138)\ **Post date:** [March 9, 2017, 1:20pm UTC](https://boards.straightdope.com/t/trumpcare/781625/84 "2017-03-09T13:20:01Z")
> [@Gyrate](#): > > As a brief aside, there was this little exchange on Twitter recently: > > Boom. I saw that. I work with several Trump supporters. When I showed it to them they told me that The National Review isn’t really a conservative publication. It’s part of the Republican Globalist wing of the party that George W belonged to and that I can’t trust it. They say the same thing about David Frum, Mitch McConnell John McCain… Anyone who disagrees with them. It’s a crazy world. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 9, 2017, 1:32pm UTC](https://boards.straightdope.com/t/trumpcare/781625/85 "2017-03-09T13:32:39Z")
> [@adaher](#): > > But as long as insurance is something people need, we’re sticking with multi-payer. Then we’re sticking with something cruel, inefficient, and demonstrably inferior to what the rest of the civilized world is doing. I’ve yet to get a good answer to why the US can’t go single-payer UHC like the rest of the world other than “we’re stupid, stubborn, and cruel”. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [March 9, 2017, 1:42pm UTC](https://boards.straightdope.com/t/trumpcare/781625/86 "2017-03-09T13:42:25Z")
> [@BobLibDem](#): > > In typical Republican compassion, Chaffetz says the poor have to choose between their iphones and healthcare. Can’t afford thousands of dollars in premiums? Cutting that cell phone bill should cover it. As if. This story gets better! [Chaffetz uses an iPhone that was paid for out of his campaign donations!](http://www.slate.com/blogs/the_slatest/2017/03/08/jason_chaffetz_donors_might_pay_for_iphone_data_plan.html) That isn’t illegal if he used it for campaign business, and the GOP has made it legal for him to use such a phone for Congressional business as well — but _not for personal business._ (Chaffetz’ office was unavailable for comment on the rumors that he had illegally used his campaign-donated iPhone for personal business.) ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [March 9, 2017, 1:42pm UTC](https://boards.straightdope.com/t/trumpcare/781625/87 "2017-03-09T13:42:42Z")
> [@NAF1138](#): > > I saw that. I work with several Trump supporters. When I showed it to them they told me that The National Review isn’t really a conservative publication. It’s part of the Republican Globalist wing of the party that George W belonged to and that I can’t trust it. They say the same thing about David Frum, Mitch McConnell John McCain… Anyone who disagrees with them. > > It’s a crazy world. What’s their position on the sugaring of porridge? ---
**Author:** ![JackieLikesVariety](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackielikesvariety/32/296_2.png) [@JackieLikesVariety](https://boards.straightdope.com/u/JackieLikesVariety)\ **Post date:** [March 9, 2017, 1:44pm UTC](https://boards.straightdope.com/t/trumpcare/781625/88 "2017-03-09T13:44:07Z")
the states will start covering everyone\* and, gradually, everyone will be able to see this works and all the arguments against it are bogus. or, since I am channeling the Car Talk Guys, booooooooooooooooooogus. > [@](#): > > he problem with the idea of lowering Medicare eligibility is that the trust fund is already near insolvency. this is easily fixed, as Bernie showed us. so: will California be first? or is MA already covering everyone? I’ve lost track. :o \*not the same as UHC, I know, but it’s what we will get ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 9, 2017, 1:52pm UTC](https://boards.straightdope.com/t/trumpcare/781625/89 "2017-03-09T13:52:11Z")
UHC based on states should work even if we can’t get Federal level UHC. After all, most US states have more people than a lot of actual sovereign nations. It’s better if your risk pool is as large as possible and 300 million is a very nice size, but a mere several million should work. Places like Wyoming might want to ally with other nearby low-population states, though. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [March 9, 2017, 2:05pm UTC](https://boards.straightdope.com/t/trumpcare/781625/90 "2017-03-09T14:05:47Z")
> [@Broomstick](#): > > UHC based on states should work even if we can’t get Federal level UHC. After all, most US states have more people than a lot of actual sovereign nations. It’s better if your risk pool is as large as possible and 300 million is a very nice size, but a mere several million should work. > > Places like Wyoming might want to ally with other nearby low-population states, though. If every state did it, sure. But even California would have a hard time making it work alone. States cannot run deficits. Moving people and businesses out of the state is a lot easier than moving out of the country. Any state move will not reduce federal tax burdens. California (using them as an example) supports poorer states already. It’s not about the size of the state. It’s about the financing structure and how it differs from a separate country. The differences are significant. ---
**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:** [March 9, 2017, 2:49pm UTC](https://boards.straightdope.com/t/trumpcare/781625/91 "2017-03-09T14:49:13Z")
> [@Grim\_Render](#): > > I believe you could describe the ACA as a step closer to the German system, which is not a bad one. Only in the sense that if I take one step eastward I’m a step closer to China, but I’m still nowhere near it. The German system is a very good one, but the differences between it and the ACA are vast and fundamental. Much is sometimes made of the fact that it’s a multi-payer system, plus it includes private insurance, but at its core it’s a universal system premised on egalitarian social principles and is nothing like the US model. Private insurance is only available to those in a high salary bracket under strict conditions, or visitors, and only about 10% of the population opts in. The multi-payer aspect is pretty much irrelevant because in the statutory (public) system costs are community rated and not risk rated and essentially everyone has the same coverage at the same cost, everyone is guaranteed coverage regardless of income, provider fees are standardized, and the whole thing is highly regulated. For all practical purposes, the statutory system that serves the vast majority may as well be single payer. The thing that makes it work well is precisely the kind of regulatory intervention that some like to refer to as “socialized medicine”. The sort of thing that would send American Republicans to their fainting couch in panic over incipient communism, and send health insurance lobbyists straight to their pet Congressmen with some very strict orders to make sure it never saw the light of day. Yet as long as “free markets” govern health care, the thing will continue to be an exorbitantly costly, inhumane, hopeless mess. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [March 9, 2017, 3:00pm UTC](https://boards.straightdope.com/t/trumpcare/781625/92 "2017-03-09T15:00:53Z")
> [@adaher](#): > > If you’re referring to single payer, that’s not happening either. **The general outline of ACA is our health care system now and will be for the next 100 years. All that’s left to be debated are the details.** As much as I usually disagree with **adaher** , this assertion is on the money. Although I think that Trumpcare is a terrible and inhumane policy, its mere _existence_ proves that the paradigm has permanently shifted and that the Democrats have won the foundational philosophical argument: It _is_ the responsibility of the federal government to ensure that the population has health insurance. Clearly, the GOP differs wildly from the Dems in terms of (a) how _many_ people the government should assist (as few as possible), and (b) how _generous_ such assistance should be (as stringent as possible), but the Republicans know that the actual _responsibility_ for the government to fulfill these functions now exists. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [March 9, 2017, 3:20pm UTC](https://boards.straightdope.com/t/trumpcare/781625/93 "2017-03-09T15:20:13Z")
> [@NAF1138](#): > > I saw that. I work with several Trump supporters. When I showed it to them they told me that The National Review isn’t really a conservative publication. It’s part of the Republican Globalist wing of the party that George W belonged to and that I can’t trust it. They say the same thing about David Frum, Mitch McConnell John McCain… Anyone who disagrees with them. > > It’s a crazy world. Meh. Just tell them that you’re disappointed to learn that they hate everything that makes (or could make) America good, and bid them good day. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [March 9, 2017, 3:44pm UTC](https://boards.straightdope.com/t/trumpcare/781625/94 "2017-03-09T15:44:28Z")
I happened to lunch with Malcolm Wright, the Chief Executive of NHS Grampian, today. He said that the NHS budget per person is £1850 per year (~$2250). That equates to US$700B for the whole of the US. Add in additional private insurance, and you’d still be less than $1T. [Business Insider](http://uk.businessinsider.com/ap-new-peak-for-us-health-care-spending-10345-per-person-2016-7?r=US&IR=T) says that US spending is expected to surpass US$10,000 per person. Four times what we spend. Do the maths: $3.35T vs $1T. I know I’m preaching to the converted here but some facts might help. ---
**Author:** ![Fiveyearlurker](https://avatars.discourse-cdn.com/v4/letter/f/da6949/32.png) [@Fiveyearlurker](https://boards.straightdope.com/u/Fiveyearlurker)\ **Post date:** [March 9, 2017, 4:10pm UTC](https://boards.straightdope.com/t/trumpcare/781625/95 "2017-03-09T16:10:51Z")
The Republicans goal with this bill is not to have a bill that passes, it’s to have a bill that fails that they can blame on someone else (hopefully Democrats) and use to win reelection; if you want to repeal Obamacare, we need more Republicans elected. ---
**Author:** ![QuickSilver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quicksilver/32/7832_2.png) [@QuickSilver](https://boards.straightdope.com/u/QuickSilver)\ **Post date:** [March 9, 2017, 4:29pm UTC](https://boards.straightdope.com/t/trumpcare/781625/96 "2017-03-09T16:29:35Z")
> [@Fiveyearlurker](#): > > The Republicans goal with this bill is not to have a bill that passes, it’s to have a bill that fails that they can blame on someone else (hopefully Democrats) and use to win reelection; if you want to repeal Obamacare, we need more Republicans elected. What?.. :dubious: ---
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [March 9, 2017, 5:10pm UTC](https://boards.straightdope.com/t/trumpcare/781625/97 "2017-03-09T17:10:59Z")
According to the LA Times, the vast majority of Californians will not be eligible for the tax credits of the proposed plan, regardless of age or income. Essentially, the issue is this: The plan proposed by Republicans does not allow tax credits for any plan that pays for abortions. California state law requires all health plans to pay for abortions, with very limited exceptions. ---
**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:** [March 9, 2017, 5:19pm UTC](https://boards.straightdope.com/t/trumpcare/781625/98 "2017-03-09T17:19:46Z")
> [@suranyi](#): > > According to the LA Times, the vast majority of Californians will not be eligible for the tax credits of the proposed plan, regardless of age or income. > > Essentially, the issue is this: > > The plan proposed by Republicans does not allow tax credits for any plan that pays for abortions. > California state law requires all health plans to pay for abortions, with very limited exceptions. Have any Republicans acknowledged this little problem? ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [March 9, 2017, 5:37pm UTC](https://boards.straightdope.com/t/trumpcare/781625/99 "2017-03-09T17:37:38Z")
> [@Czarcasm](#): > > Have any Republicans acknowledged this little problem? I strongly suspect that Republicans don’t see this as a problem. For them, it’s more of a feature than a bug. ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [March 9, 2017, 5:43pm UTC](https://boards.straightdope.com/t/trumpcare/781625/100 "2017-03-09T17:43:41Z")
> [@steronz](#): > > I haven’t seen it spelled out anywhere but I assume that first leg is still present? Insurance companies can’t deny coverage for preexisting conditions? > > Doesn’t that just mean that nobody will buy insurance unless they absolutely need it and happily pay the 30% premium when they get sick? Ding ding ding. We have a winner. In a nutshell, this is the problem. Look, forget everything else. Forget it. Forget the seven pages devoted to lottery winners. Here’s how health insurance works: 1. If everyone is forced to get it, it works. It has a chance of working, anyway. 2. If people aren’t forced to get it, it does not work. This is Economics 101. If there is no “individual mandate” then people are inclined to buy insurance only when they feel they are likely to need it, and, as a result, insurers are automatically suspicious of anyone who wants to buy insurance. The only way this ridiculous “health” insurance system will last six weeks is with a network of tent poles in fifty different places desperately trying to keep adverse selection from collapsing down upon it. [Previous page](https://boards.straightdope.com/t/trumpcare/781625.md?page=4) [Next page](https://boards.straightdope.com/t/trumpcare/781625.md?page=6)