The Weiner Component V.2 #23 – Obamacare: Repeal Now, Replace Later

The Senate version of the “Repeal and Replace” Affordable Health Care Bill (Obamacare) did not have the votes needed to pass in the Senate.  There are 52 Republican Senators and 48 others; 46 Democrats and two independents who vote with the Democrats.  Any passing bill needs at least 50% of the 100 votes to pass.  A number of Republicans and all Democrats oppose it.

 

To date the House of Representatives has passed a Draconian replacement bill for Obamacare which transfers a good part of the money spent on healthcare to tax reduction for the upper two percent and for essentially large corporations and massively increases the amounts that Obamacare recipients will have to pay.  It took the Speaker of the House of Representatives, Paul Ryan, two tries to pass this bill and even then some Republicans opposed it.

 

The Senate, behind closed doors, with a small select committee of senior male Caucasian Senators, developed its version of the replacement and tax cut bill.  This document achieved immediate objection from both Democrats and some Republicans.  It was modified and still did not have enough Republican votes for it to pass.  The Senate left for its July 4th Recess without taking any action.

 

On Friday, June 30, 2017, it was suggested by Senator Ben Sasse, the Junior Republican Senator from Nebraska, working with President Trump, that the Senate, as soon as it comes back from its holiday Recess, repeals Obamacare and replaces it later.  This plan actually emerged from a Koch Brothers Think Tank.  Just prior to July 4th President Trump strongly supported this plan.  So far the Recess is over and nothing has happened in the Senate.

 

It seems that basically Trump is always more interested in winning, in getting his way, than it keeping his word.  As a candidate he promised his constituents that they would have more and better medical care under his presidency than they currently had and that it would cost them less money.  He currently seems to support the opposite position.

 

If this were to be done, and a bill were passed in the Senate, it would be done, in all probability, in stages with Affordable Health Care gradually being done away with.  The Senate bill would require that at some point in the near future the replacement bill was to come into being.  The problem with this type of legislation is that it makes future assumptions that may not come to pass.  Several years ago, in 2013 under the Obama Presidency, the Republican majority in the House of Representatives, where all money bills have to begin, wanted to reduce government spending.  It could not make the entitlement cuts it wanted.  Subsequently a bill was passed into law in that year that said cuts would be made at a specific future point or all government spending programs would be reduced at that time and yearly thereafter.  This bill was called The Sequester.  When that point of time was reached no tax cut law had come about and The Sequester operated from that point on.  It took special legislation to properly fund the military after the automatic cuts came into being.

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If the effect of this bill was instantaneous the implication of this action, repealing now and replacing later, would be devastating upon the 22 plus million American citizens who currently have Affordable Health Care.  In all probability, if the Senate were capable of doing this, the next step would be immediate Tax Reform which would be to significantly reduce taxes for the upper two percent of the population and the large corporations.  The effect of the two acts would be devastating upon the Aged, the dependent young, and the general population of the United States.

 

First off: a large proportion of these people cannot afford any kind of medical coverage on their own.  A fair percentage of them are receiving crucial treatments that keep them alive.  These would stop immediately; and so would many of their lives.  The others would mostly survive, but not well.  Paying many rural and some urban hospitals would cease or decrease significantly causing a large number of them to shut down permanently.  In addition payments to Planned Parenthood would decrease when the government stopped contributing to them.  Essentially poor women, who cannot afford medical care, would lose the care they have ending breast cancer and other vital tests for these people and causing a significant increase in their rates of series illness.  Among other things the overall death rate would greatly increase.  And this does not even consider what will happen to young children who do not receive any medical care.

 

The overall effect of this besides the increase in the death and untreated illness rate will be to lower the overall Gross Domestic Product; the GDP, the level of wealth produced in the United States.  Spent money has a velocity; it is spent three to twelve times.  It has a volatility in terms of increasing productivity.  Money withdrawn from the overall cash flow has the opposite effect.  Every dollar withdrawn reduces the GDP by three to twelve dollars, shrinking productivity and employment.  The sudden withdrawal of these billions of dollars will cause an instant decrease in goods and services in billions to trillions of dollars.

 

The irony of this is that a large percentage of the people who would be affected are those who voted for Trump.  For example, West Virginia would become a desolate state with the government financially incapable of helping their citizens to even survive.  This is also true for a number of other states that strongly supported Trump in the Presidential Election.

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If by some strange miracle this bill were passed in the Senate and the House of Representatives also passed an identical bill the taxes of President Trump and the members of his Cabinet’s taxes would be greatly reduced in a shrinking depressed economy.  The upper two percent and the large corporations would be paying less in taxes but their earnings would in all likelihood quickly become less than they are now.  Trump’s hotels would have to decrease their room or suite prices and his cohorts would end-up earning less than they are now for similar reasons.  In essence it would be an instant depression, everybody would be hurting.  And this includes the upper two percent and the large corporations.

 

On Saturday, June 30th, Mitch McConnell, speaking in Elizabethtown, Kentucky, stated that he would not present a “Repeal Now, Replace Later” bill in the Senate.  Will he keep his word?  That’s unknown.  It all depends upon what is happening in the overall society.

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Also if the Senate is finally able to pass some sort of repeal and replace bill it will in all probability be different from that of the House.  This will mean a Conference Committee consisting of members of both Houses of Congress.  The House of Representatives had problems passing the bill that a majority of Republicans there agreed upon.  If they later have to compromise upon their bill and the Senate’s bill the process may become impossible.  It took great effort on Paul Ryan’s part to bring in the far right, the so-called Freedom Caucus.  Also the entire House of Representatives is coming up for reelection in November of 2018.  The probability is that the Conference Committee will not be able to come out with a compromise and the bill will die in committee.  We may not officially know this until the end of 2017 shortly before in Midterm Election..

 

In addition, in order to get a majority vote, McConnell may have to compromise with the Democrats in the Senate.  This could produce fascinating results.  The majority of Democrats currently seem to be supporting a single payer system; that would be the Federal government, which would drop the cost of the middlemen in Healthcare.

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Affordable Health Care premiums seem to be rising significantly at this time.  There are numerous reasons for this but perhaps the most significant one is the fact that the insurance industry has no idea what the immediate future of Health Care will be.  Ordinarily the Insurance Companies have people, actuaries, who can predict generally what will affect them during the coming year and on the basis of these presumptions, with a strong safety factor added, the coming year’s premiums are worked out.  But with what is or is not currently happening and not happening with the Republicans in Congress this process is impossible.  Consequently the experts in the insurance companies are projecting the highest possible increase in order to protect their companies in this period of mass confusion.

 

As long as Congress is about to act the madness persists.  And Congress has been about to act since January 20, 2017, when Donald Trump became President of the United States and a new Republican dominated Congress came into being.  It took the House of Representatives two tries to finally pass a Draconian health bill which would wipe out Affordable Health Care after seven years of existence, give the wealthy a massive tax cut, and introduce a new form of voluntary health care which most people currently on Obamacare could not afford.  Here much of what the Federal Government spent on Affordable Health Care would have to be paid by the recipients of the plan.  This, if it became law, would remove nineteen million people from any type of health insurance.

 

To date the Senate Republicans have not been able to get any type of plan passed.  Obamacare, with ever-rising premiums, remains in existence.  In fact it has become far more popular since Trump assumed office.  To many people it has become a life and death issue and they have dramatically let their congressmen know this.

What happens now?  Has Congress reached a point of total non-functionality with nothing happening or will they come up with a bill both Houses of Congress can agree upon?  If they do how will this affect the American people?

 

Currently Chuck Schumer has sent a message to President Trump to call a summit of all 100 Senators to work on a bill.  To date Trump has ignored this.

The Weiner Component Vol.2 #11 – Trump & the Republicans: “Repeal & Replace”

The United States is now into being well over 60 plus days of Donald Trump as

President and Republican majorities in both the House and Senate. With the exceptions of a new Justice on the Supreme Court and a military raid on a Syrian air base.  Nothing significant has happened in the nation’s capital except that most members of Congress are working a three day week and have taken a two week Easter break.  Trump’s executive orders limiting the movement of Muslims from seven and then six Middle Eastern countries have been put on what looks like a permanent hold by the Federal Courts.

 

The members of the House of Representatives are on a two week vacation or break from the hard work they’ve been doing accomplishing virtually nothing except noisy Town Hall meeting with their constituents.

 

When the Democrats had a majority in both Houses of Congress the Republicans had loudly and persistently decried that they were ruining the Country with their irresponsible legislation like Affordable Health Care or as they like to call it, “Obamacare” and by supporting such national organizations like Planned Parenthood.

 

Also it seemed as far as the Republicans were concerned that nothing worthwhile could come from a Black, Democratic President. Now there is a white Republican President and a Republican dominated House of Representatives and Senate and to date, more than two months since they assumed power, nothing worthwhile has come from them except endless squabbling.

 

Their first major piece of legislative business was to get rid of Obamacare. They have been denouncing it since it first came into existence. It was signed into law on March 23, 2010, a little over seven years ago. Since that day, to hear Republican legislators speak about it, an individual gets the impression that it is worse than leprosy.

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The problem, as far as President Donald J. Trump is concerned, which he recently discovered, is that the healthcare law is very complicated. Trump’s understanding of a law is of something that can be put on a single sheet of paper with wording that will not even cover the entire page. The Affordable Health Care Law has to be about a thousand pages long. That makes it very complicated. It will take more than the passage of one simple law to be completely done away with.

 

On Thursday, March 23, 2017, the seventh anniversary of the law, the repeal and replace bill was pulled by the Speaker of the House of Representatives because it didn’t have the votes to pass in the House. Trump, presumably in a moment of disgust, outrage, or masterful negotiation, sent some of his aids to sell the bill to the doubting members of the House. Trump wanted the bill voted up or down the next day. He wanted to know who among the Republican Party in the House were his supporters and who “supports Nancy Pelosi,” the Democratic leader. No Democrats are voting for the bill.

 

What is the problem in the House with this bill? It seemed that the members of the far-right Freedom Coalition were against the bill because it was too lenient, while more moderate Republicans were against the bill because it would remove 24 million people from health care coverage. 14 million, according to a non-partisan Congressional Office, will lose their coverage within a year and the additional 10 million will lose it over a longer period of time.

 

House Speaker Paul Ryan’s, who developed the Bill from values he has held for years,  goal was to make health care accessible to everyone while keeping the minimum wage at its present low level. The problem that emerged with this prospective bill was that most people could not afford health care under the new proposed bill.

 

Younger participants will have their premiums reduced while older people would have their premiums massively increased. The Speaker of the House has stated that he will be making Health Care available to everyone. The catch there is if they can afford to pay the premiums. The Federal Government will give tax credits to the needy. But the problem is that most if not all of the needy will not have the money to afford the premiums and may be earning so little that they pay no income taxes.  Consequently the tax credits would be worthless.

 

This is particularly true since the minimum federal wage is seven dollars and twenty-five cents an hour. This means that a fair percentage of the population, particularly in red states where people believed in and voted for Trump, are earning $290 a week before unemployment and Social Security is taken out of their earnings. A goodly number of these people, who currently have Obamacare would lose it and be forced to go to ER, emergency rooms at hospitals. Under the proposed bill they will probably die prematurely. Many will face a choice between medication, food, or rent. This apparently is Paul Ryan and Donald Trump’s solution to Universal Medical Care. It is also a way of having the government significantly reduce its spending and being able to cut taxes for the rich and the corporations.

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According to one pole 17% of the population supports the Republican Health Care Bill, which has been labeled Trumpcare or Ryan-care. 56% oppose it. Virtually every Congressional District in the United States opposes the bill. If it passes in the House it should make for interesting voting in November of 2018.

 

On Friday, March 24, 2017 Trump and Ryan’s health care bill was pulled just minutes before it was supposed to come up for a vote. The Republicans, who have a wide majority in the House of Representatives, did not have enough votes to pass it. Presumably this was done on orders from Trump. Obamacare will continue to exist. The people of the United States in mass rallies throughout the country have demanded it. The Republicans have buckled down to the will of the majority. I suspect mainly because they don’t want to lose their seats in the House of Representatives.

 

Interestingly, Benjamin Franklin wrote toward the end of his career, “In free governments the rulers are the servants and the people their superiors and sovereigns.” It took massive protest movements for this point to be made throughout the country.

 

After a period of silence on the subject Paul Ryan is now talking about a new and better version of the Health Care Bill. They are again talking about it and will continue to work on developing it after their two week break.

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Listening to the President one got the impression that Trump never really examined the Affordable Health Care Law. It seems that he doesn’t like to read; that he gets most of his information from watching television. Trump promised to expand the plan and lower the cost when he was a candidate without really being aware of what he was talking about. I would suppose he is a 70 year old attention deficit adult. I would guess he knows things by instinct rather than by investigation.

 

Many of the House Republican legislators were announcing on the floor of the House on Friday how many of their constituents would lose health coverage if the bill were passed. The numbers were staggering. One could see what would probably happen in votes for the Democrats in the Midterm Election of 2018.

 

Ryan’s plan, had it passed would have decimated the current system. Again Trump probably had not bothered to examine the bill. It would have cut out the lowest rungs of society, all 14 million of them. This bill was rushed through the House without hearings or anything. It was supposed to be the fulfillment of the Republican dream of getting rid of Obamacare, after seven years of its existence and the Republican dominated House of Representative passing over 60 bills over the last seven years repealing Obamacare. None of these bills ever reached the Senate.

 

Ryan’s bill would have transferred much of the payment for medical treatment from the Federal Government back to the recipients of that medical treatment. Somehow the reduction in Federal costs would generally match Trump’s tax cuts, a little over 8 billion dollars.

 

This would have been very helpful to the Republicans in getting their tax cuts through Congress. It would be the reverse of Robin Hood’s behavior which was taking from the rich to help the poor. Instead Ryan-care was to take from the poor in order to help the rich.

 

Trump then spoke of moving on to his next legislative project, what he calls tax reform. This is mainly tax relief for both the top two percent of the population and for lowering the cooperate taxes. It would seem that they can’t afford to cut taxes without lowering medical costs

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The ultimate irony here is that Affordable Health Care was a Republican generated plan which, if I remember correctly, was generated for Mitt Romney when he was Governor of Massachusetts by Citizens United, a far-right Think Tank.

 

The plan worked well in that state and Romney got and took the credit for it.  In 2012, when Romney ran against Barack Obama as the Republican candidate for the presidency he denounced the plan for which he had been responsible.

 

The plan utilizes private enterprise to develop a Universal Health Care System. It follows Republican principles about private ownership. President Obama and the Democrats used it because they thought it would get Republican support in Congress. Not one Republican Party member voted for the bill.

 

It would have been far more practical and much cheaper for the Federal Government to become the insurer and set up a single payer plan throughout the United States. Virtually every single government that has universal health coverage for its people has done this and their overall costs are half or less than the U.S. pays for both medical care and pharmaceuticals. The Republican problem in “repealing and replacing” Obamacare is that they’re trying to improve upon their own plan and it’s not going to happen.

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The commitment to Socialized Medicine for the entire population requires much more than the Federal Government has been able or willing to do so far. What we have seen is a semi-voluntary Republican plan that includes the private sector. What we need is a plan that also supplies doctors and cuts out the profits of the middle men.

 

Becoming a medical person is a long and expensive process. There are many individuals who would go into this but cannot afford the time without earning anything or the expense of the process. What is needed first is a single provider who operates on a non-profit basis, and that would be the Federal Government. The Government Agency that would handle this then needs to be able to deal directly with the medical and pharmaceutical facilities that provide both the doctors and the medicines for the public. This could be done by having the Federal Government set up medical learning facilities or contract to pay the costs of becoming a doctor at the existing medical universities or both. The Government also has to control the costs of the medicines.

 

This requires a major monetary investment over a goodly period of time. The Federal Government would also have to set up a scholarship system where worthy candidates would have their tuition and possibly their living costs paid

 

Also right now the pharmaceutical companies are free to charge what they will. This is currently true because they are protected by Congress. Today the major contributor to the Republican Party are the Pharmaceutical Companies. The cost of medical treatment in other industrial countries is less than half of that in the United States. Also medicines cost a fraction of what they do in the U.S. Medical Care should be a right that everyone has. The cost of it could be easily added to the income tax with everyone paying their fair share.

English: Nations with Universal health care sy...

English: Nations with Universal health care systems. Nations with some type of universal health care system. Nations attempting to obtain universal health care. Health care coverage provided by the United States war funding. Nations with no universal health care. (Photo credit: Wikipedia)