Thursday, June 29, 2017

The lack of support for their health legislation should make Republicans sick. The remedy is a single payer system.

We should rebrand the House AHCA and Senate counterpart (“Better Care”) as the Make America Sick Act (MASA). The public, at least most of them, understand why that brand would be appropriate. Some senators finally are catching on too. The Republicans don’t like the idea of a single payer system but their own legislation makes a compelling argument for it.

Vox Populi: We do not like these bills!

Chris Cillizza (CNN/Politics/The Point) says This poll number on health care should make Senate Republicans queasy.

Here’s an indisputable fact: The health care legislation Senate Republicans were forced to delay a vote on Tuesday is very, very unpopular with the public.

Less than 1 in 5 people (17%) approve of the Senate bill, according to a new NPR/PBS Newshour/Marist poll released Wednesday morning. A majority – 55% – disapprove. The numbers are disastrous among Democrats (8% approve) and independents (13%) but perhaps most surprisingly bad among Republicans – just 1 in 3 (35%) of whom approve of the Senate legislation. More self-identified conservatives disapprove of the bill (34%) than approve of it (31%).

Worse (for the Republican Senators), a poll by USA Today has the approval of the Senate Bill at only 12% of those Americans surveyed.

More Senators come out against Senate health bill

And here’s more bad news, also from CNN: Senate punts, then 3 new Republicans oppose health care bill.

Three Republican senators announced their opposition to the current draft of the Senate health care bill Tuesday afternoon, shortly after Senate Majority Leader Mitch McConnell decided to delay a vote on the plan until after the July 4 recess.

Kansas Sen. Jerry Moran, Ohio Sen. Rob Portman, and West Virginia Sen. Shelley Moore Capito are the latest Republicans to say that they oppose the bill.

The senators had not explicitly stated their opposition prior to McConnell’s decision to delay the bill.

In a joint statement Tuesday, Capito and Portman said they opposed the bill in part because of concerns they have about the affect its Medicaid policies would have on the opioid epidemics in their states.

However, do not go dancing in the streets just quite yet. Those three opposing senators are not nails in the “Better Care” coffin. Their opposition may be squishy: “All three senators remained optimistic in their statements that the Senate will eventually be able to draft a better bill for the people in their states.”

And one Senator who had committed to voting against even having a vote on the Senate bill, Dean Heller from Nevada, may be caving in to pressure from a super PAC’s ads.

Just how realistic a vote is after July 4 remains unclear. At least one senator who had publicly opposed the procedural vote McConnell had hoped to take Tuesday — Dean Heller (Nev.) — indicated that he was willing to reconsider his initial opposition, if the bill was going to be reworked.

At the White House, Heller playfully but pointedly complained about a Trump-allied super PAC that was airing ads against him in Nevada. By Tuesday night, the group had decided to pull the ads, and Heller had signaled to McConnell that he would continue to engage — far from a “yes” vote, but open to discussing his concerns. Heller’s willingness to deal prompted the super PAC to back down, said two Republicans familiar with the deliberations, although a Republican familiar with Heller said he had never closed the door on talks.

Relief for the Rich

On PBS News Hour (via Daily Beast) Billionaire Warren Buffet weighed in on, as he put it, the “Relief for the Rich Act.”

Warren Buffett is not happy with the Affordable Care Act repeal bill.

In a recent interview with PBS NewsHour, Buffett spoke with Judy Woodruff about the proposed bill.

He even brought his tax return.

Buffett told Woodruff, “If the bill that passed the House with 217 votes had been in effect this year, I would have saved $679,999, or over 17 percent of my tax bill.”

“There’s nothing ambiguous about that. I will be given a 17 percent tax cut. And the people it’s directed at are couples with $250,000 or more of income,” he added. “I have got friends where it would have saved them as much as—it gets to the $10-million-and-up figure.”

Buffett went as far as to say, “You could entitle this the ‘Relief for the Rich Act.’”

“I think members of the Senate and the House get $174,000 a year. But most of them have — if you look at the disclosures, they have substantial other income. If they get to higher than $250,000, as a married couple, or $200,000 as a single person, they have given themselves a big, big tax cut if they voted for this.”

Buffett has been an advocate for tax increases on the wealthy for many years.

Given all that hoopla, haranguing, and political hell, there must be a better way to move ahead on health care in America, right?

Medicare for All

Robert Reich offers just such a direction in It’s Time for Medicare for All.

Mitch McConnell is delaying a vote on the Senate Republican version of Trumpcare because he doesn’t yet have a majority.

Some Senate Republicans think the bill doesn’t go get rid of enough of the Affordable Care Act. Others worry that it goes too far – especially in light of the Congressional Budget Office’s finding that it would eliminate coverage for 22 million Americans.

What should be the Democrats’ response? Over the next weeks or months, Democrats must continue to defend the Affordable Care Act. It’s not perfect, but it’s a major step in the right direction. Over 20 million Americans have gained coverage because of it.

But Democrats also need to go further and offer Americans a positive vision of where the nation should be headed over the long term. That’s toward Medicare for all.

Reich then lists all the reasons why that - a single payer system - is the way forward.

Reich argues that we as a nation spend more on health care but yet are sicker than other developed countries. Check out his post for details (that you probably already know).

Medicare for all would avoid all these problems, and get lower prices and better care.

It would be financed the same way Medicare and Social Security are financed, through the payroll tax. Wealthy Americans would pay a higher payroll tax rate and contribute more than lower-income people. But everyone would win because total healthcare costs would be far lower, and outcomes far better.

A Gallup poll conducted in May found that a majority of Americans would support such a system. Another poll by the Pew Research Center shows that such support is growing, with 60 percent of Americans now saying government should be responsible for ensuring health care coverage for all Americans – up from 51 percent last year.

Democrats would be wise to seize the moment. They shouldn’t merely defend the Affordable Care Act. They should also go on the offensive – with Medicare for all.

If Dems do that, they might score a big win. We are closer to a single payer system than you might think because Whatever happens, the GOP is bringing us a whole lot closer to single-payer, explains Paul Waldman (Washington Post/Plum Line).

The Republican health-care bill is not dead yet, but it’s in rough shape. Whether it passes or not, it has been an utter debacle for the GOP, making the Affordable Care Act they’re trying to undo more popular than ever, energizing the Democratic base, complicating the relationship between President Trump and Congress and sowing justified distrust of Republican motives among the broader public.

It has also done something else: moved the debate on health care in America to the left and made single-payer much more likely.

Even if the Senate bill fails, Republicans give up and move on to tax reform, and the status quo remains in place, this debate will have had profound effects on our politics. While the Democratic Party may have been moving to the left on health care anyway, its momentum in that direction may now be unstoppable. And the entire country will be more receptive than ever to the arguments Democrats will make. This, by the way, will also be the case if the GOP repeal effort succeeds, because it will make so much that people hate about our health-care system a lot worse.

Waldman talks about the politics that lead to his conclusion citing, for example, Senator Elizabeth Warren’s bold statement in support of single payer. He then suggests a path from where we are now to a credible and sustainable single payer system that would satisfy most members on both sides of the political aisle.

It’s important to keep in mind that “single-payer” isn’t one thing — if you look around the world at highly developed countries, there is a spectrum of health systems with various levels of public and private involvement. But what they have in common is that they achieve universal coverage while working better and costing less than ours. We could well have 15 Democratic presidential candidates proposing 15 different kinds of single-payer. Some may be highly socialized systems — what Bernie Sanders would likely advocate if he runs again — but the ones that are most appealing could be hybrid systems of the kind that have been successful in countries such as France. The way it works is that there’s a government plan that covers everyone’s basic needs, but you can also buy supplemental private insurance to get as many more benefits as you want.

Among the advantages of a hybrid system is that one can actually see a path from where we are now to there. That path runs through Medicaid, which now covers nearly 75 million Americans. What if we auto-enrolled everyone under 65 in Medicaid — it’s there if you need it, but if you have different insurance you’d prefer, go ahead and use that instead. No one would be without coverage. Private insurance would evolve into something you buy to fill in the gaps and get perks that Medicaid wouldn’t provide. Instead of covering all your health care, employers could provide the supplemental private insurance.

As a political matter, you could sell this as something that we could transition to over an extended period, and as a system that satisfies the goals of both liberals and conservatives. Liberals get the universal coverage and security they want, and conservatives get the freedom they want — if you’re rich enough to buy a supplemental plan that includes deliveries of Dom Perignon during any hospitalization, go right ahead.

That isn’t to say that Republicans wouldn’t resist and there won’t be more intense arguments about health care, because they would and there will be. But by handling this debate so terribly and proposing something so monstrous, Republicans have opened up the space for Democrats to go much further than they’ve been willing to before. It’s not impossible to foresee Democrats winning the House in 2018, then taking the presidency and the Senate in 2020 — and then taking the first steps toward making single-payer health care in America a reality.

It comes down to this - Reich’s conclusion:

If Republicans succeed in gutting the Affordable Care Act or subverting it, the American public will be presented with a particularly stark choice: Expensive health care for the few, or affordable health care for the many.

Even if they don’t gut ACA, it still comes down to that.

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