US General Election 2016

{{ Well looks like Obama wins! Health care in the US remains at least in part a responsibility of government to provide. Be interesting to see what the self proclaimed greatest negotiator in all of time and space has to say now! Wonder if his supporters are sick of winning yet?! }}}

https://www.nytimes.com/2017/03/24/opinion/the-trump-elite-like-the-old-elite-but-worse.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-left-region&region=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region&_r=2

Now I hope the Democrats will come around and say "see, you need us.  Now if you'll listen to us, we'll try to listen to you, and we may come up with something that can pass.  Maybe an elegant blend of the best parts of Obamacare and the recent Ryan bill."



Okay, lets get real: the Democrats will obstruct, the Republicans will throw up their hands and start pulling funding wherever they can, and we'll end up with a worse mess than we were in before Obamacare.

I'm hoping this happens, but fear it won't. even if it does happen, the people right above the current medicaid line would not be helped:

Trump and the GOP should face it: There's only one option left to fix health care
Robert Laszewski, president of Health Policy and Strategy Associates
CNBC.com

Now that the American Health Care Act has been yanked, after GOP leadership failed to rustle up enough votes to get it passed, it is clear that an Obamacare fix cannot be negotiated with hard-line Republican conservatives.

But there is another option for getting a bill passed. President Trump and the Congressional Republican leadership would have a much easier time working with the Democrats—with whom they have more in common.

After almost two months of collaborative effort by the House Republican leadership and the Trump administration, it is now crystal clear that the ideological differences between hard-right conservatives and most Republicans, are so wide, a deal cannot be done that accommodates them.

President Trump and the House leadership crafted an Obamacare repeal and replace bill that would have continued advanceable tax credits for individuals buying their insurance in the marketplace. They also crafted a bill that at least would have provided a "soft landing" for those now covered in the Obamacare Medicaid expansion.

But the hard-right Republicans who scuttled this bill, including most in the Freedom Caucus, don't want to continue the health-care entitlements. They don't want Medicaid to cover anyone but the poorest and most disabled for even one more day. They certainly don't want any able-bodied people who could be working getting any such entitlements. And, they don't want any premium credit entitlements to help lower and middle-income people to buy health insurance.

At best, they would agree to make health-insurance purchases tax deductible—something that would help those in higher tax brackets but do little or nothing for those who are in the lowest brackets or pay no income taxes.

With a Republican House majority of only 21 votes, these hard line conservatives can scuttle any bill—and for these reasons they have scuttled this one.

"Even if the Republican leadership gave these far-right Republicans what they want, the moderate Republicans would likely rebel and such a massive rollback of Obamacare would throw millions off their coverage, could well lead to a huge 2018 election defeat."
The terrain in the Senate is really no different. With a two-seat majority, at least three Republican Senators generally share the views of these hard-right House conservatives—Ted Cruz of Texas, Rand Paul of Kentucky, and Mike Lee of Utah.

Even if the Republican leadership gave these far-right Republicans what they want, the moderate Republicans would likely rebel and such a massive rollback of Obamacare would throw millions off their coverage, could well lead to a huge 2018 election defeat.

Now, the president has threatened to skip fixing Obamacare and let it fail. He will get his wish. The Obamacare insurance exchanges are simply unsustainable in their present form. With only 40 percent of the subsidy eligible signing up after three years, the risk pool is nowhere near the goal of getting 75 percent to sign up to assure enough healthy people are paying into the program to cover the costs of the sick.

Health insurers that I have talked to are already working on their contingency plans for 2018 should Obamacare not be repaired. Things are so unsustainable that the shrinking number of health insurance companies left in the Obamacare market are giving serious thought to whether or not they will even participate, and if they do just how much higher — and they will have to be much higher — to set the rates.

The short-term Medicaid outlook is better in the wake of this failure. Without a new bill, the program will continue and will be fully funded. In fact, the Trump administration has already signaled it will be open to giving the states much more flexibility in how they can efficiently run their Medicaid programs — albeit without the more far reaching reforms the scuttled bill would have created.

All of this takes us to the Democrats.

Trump and the Republican leadership have said that everyone should at least have access to health insurance. The Democrats generally agree.

Trump and the Republican leadership have said that we should keep the pre-existing condition reforms and kids should be able to stay on their parent's plans until age-26. The Democrats agree.

Trump and the Republican leadership believe that there should be advanceable tax credits — premium subsidies — available to those in the lower and middle-income categories. The Democrats generally agree.

Trump and the Republican leadership believe that, while continuing to protect consumers, the insurance-market rules need to be made more efficient so that the insurance companies can have the vibrant market they need to offer consumers the insurance products they want. The Democrats generally agree.

The hard-right conservatives, on the other hand, disagree with almost every one of these things. For example, they demanded that most of Obamacare's Title 1— that includes the consumer protections — had to go.

I don't mean to gloss over the very significant differences that remain between Democrats and the Republican leadership. But as a place to start a conversation, the defeat of the Republican health care bill at the hands of the most conservative House members, makes it clear the Democrats have more fundamental agreements with the Republican leadership than the Freedom Caucus ever did.

The only way to get to a solution here is for President Trump and the Republican leadership to recognize who their real potential partners are.

In the end, the only way to a sustainable solution to health-insurance reform is one that has bipartisan support. Without that, the Democrats will just reverse anything the Republicans do once they are inevitably back in power.

I don't know about you, but I am sick and tired of the seven-year long partisan bickering over health insurance. The only solution to that is a bipartisan solution.

Commentary by Robert Laszewski, the president of Health Policy and Strategy Associates, LLC, who has twenty years of experience in the insurance industry, serving as a chief operating officer for nine of those years, before beginning his Washington, D.C. policy and market consulting business.

http://www.cnbc.com/2017/03/24/trump-and-the-gop-should-face-it-theres-only-one-option-left-to-fix-health-care-commentary.html?__source=yahoo%7Cfinance%7Cheadline%7Cheadline%7Cstory&par=yahoo&doc=104363395&yptr=yahoo&hl=1&noRedirect=1

{{ The solution is obvious- just you know Americans!- 32 first world countries in the world, 31 of them have some form of single payer health care funded by government through taxes. The only country in the entire world who thinks health care should be at the mercy of for profit insurance and dictated solely by the markets is America. Totally on its own.
And out of the emerging economies who are in the process of creating a health service not a single 1 of them is following the US model- I wonder why? Could it be because its wrong, immoral, sick, twisted, and most of all doesn't work for the majority of people? }}}

Actually it works okay for people who have at least moderate income jobs from a large employer (including such business owners).  Who are also the people more involved in politics, which is why the system has stuck around for so long.

There are in fact benefits to have competitive medicine in that it incentivizes innovation; which has immediate benefit to the rich and eventually trickles down.  So I don't think you want to get rid of it entirely.  But a European style system for a large fraction of people is needed, badly.

{{ You still have private medicine and private insurance in Europe and the UK- if you have the money you can pay to get seen a bit quicker, to get more personal treatment, to see the same doctor and specialists every time rather than whoever is on duty that day and you can buy drugs that might not be available through the nationalised system.
You dont do away with insurance- you just have it for those who want and can afford it and they get fringe benefits if they do.
But you need a government led, tax funded health service of high standard as possible for everyone else who cant afford it.
No one should suffer pain and disease and illness just because they are poor in a modern country and when the means of elevating their suffering is available- there is no moral argument to do so. None.
The US system is disgustingly immoral imo- it actually sickens me to my core when I hear Republicans speak about it. Its like something medieval.}}

It's totally messed up to think government should not support medicine, which despite medicaid and medicare is where the government was until Obamacare. The two M's supported people who couldn't possibly afford health insurance, Obamacare brought it to those who had a really hard time and actually had to make a choice whether to be insured or not.

I'm estimating 40% of the population could use help with insurance. Obamacare needs to be patched up, and we have a golden opportunity if the knuckleheads will wrap their heads around it. I fear it may slip away.

Tillerson: US to maintain Ukraine-related sanctions on Russia until Crimea is returned - CNN

Would not have guessed that Tillerson would be one of the more reasonable members of Trump's Cabinet, and granted that's a really low bar to clear, but still.

Wait, what?! Didn't think Trump's cabinet would cross Russia.

{{ Doesnt surprise me at all. I think at this point- given all the investigations into alleged links to Russia- the Trump side would be crazy to do anything else. Had they dropped those sanctions it would not exactly look good amid all the other circumstantial evidence doing the rounds right now. }}

And it's a passive act of staying the course rather than an active change.

{{ re recent events in Syria- words cost lives- one week ago the Trump administration through its Ambassador to the UN said the following- '"Do we think he's (Assad) a hindrance? Yes. Are we going to sit there and focus on getting him out? No".

One week later Assad uses chemical weapons against his own people. These two things are not coincidental. Trump gave Assad a free reign with those words- it said no matter what you do we are not interested in perusing you or bringing you to trial and justice for your war crimes.}}}

So...when is Trump getting impeached?

Working on it.  it seems being an obvious dumb-ass is not an impeachable offence.

It was absurd that Bannon was ever on the NSC, but he's reportedly been pulled while the Director of National Intelligence and the Chairman of the Joint Chiefs have been restored. Wonder if Kushner realized they needed to improve their optics and pushed for this behind the scenes.

https://www.bloomberg.com/politics/articles/2017-04-05/bannon-removed-from-national-security-council-role-in-shakeup

Pretty much encapsulates my view of the Trump administration so far:

This whole current situation has the very real possibility of getting out of hand now.

With all the rhetoric, who would be the one to back down if ISIS got hold of some chemicals and wiped out some more civilians as a few Syrian warplanes are dropping some bombs?

Surely Trump has to back his last statement up if the evidence 'points' at Assad and then Putin needs to back up his threat of defending that territory.

Those bloody Isrealis could probably see this as an opportunity too.

We have to remember that Obama wanted to drop some bombs but asked congress first, who rejected it.  Trump just went ahead and did it.

I have to give Trump some credit here: as bombings go it was rather genteel - nobody lives on an airbase.  And they notified the Russians first (who it seems tipped off the Syrians).  So he didn't totally fly off the handle.  

The whole situation is so complicated it's hard to judge what the "right" action is.  I feel sending Assad a message that something will actually be done when he uses chemical weapons may not be a bad thing.  but of course there's all the attendant complications.

I see this latest move as a sign that Trump is finally starting to listen to his generals. Look at the timing:

Bannon-the-Loose-Cannon removed from Security Council.
A precisely timed and executed surgical air strike coinciding with the visit of China's top diplomat.
Simultaneously deployed ships towards North Korea and top diplomats towards Russia.
And most significantly, NO tweets and NO chaos!!!

This looks to me like a play designed by the war-gamers at the Pentagon, not the name-callers at Breitbart (....and that's probably an improvement....)

I think you're right, Dave. Hopefully he'll learn how much better he looks when he actually consults with experts before acting and carefully crafts his messaging. Whether you agree with the bombings or not, the execution was the most presidential he's been so far.

{{I have an issue with the chemical attack full stop- more I look into it less sense it makes that it was Assad- since the Russian got involved he has been wining, ISIS are in retreat and the rebels opposing his government are confined to certain areas and under constant attack.
So firstly I dont see what Assad thought it would do- he could have got the same effect with conventional weapons there was no need for chemical.
And secondly he make his one true ally, Russia, look bad as they were charged by the UN to oversee the removal of all Assad's chemical weapons after Obama's 'red-line' and claimed they had done so and provided the evidence they had done so.

So on all counts- strategically no point, diplomatically disastrous, and it hangs his best ally out to dry as a result- what I cant see here is an answer to 'why would he do that?' }}}

Isn't this a case of a little terror and ethnic cleansing though? He knows Russia are backing him for now so why not?

Also, Russia + chemical weapon usage isn't exactly unheard of. Sure the Chenchens will attest to that.

True that. Dictators under stress will do whatever they think they can get away with.

Assad may think he is untouchable with Putin as an ally, plus he may have thought that Trump would 'do an Obama' and not actually follow through on threats that a red line should not be crossed. Assad probably thought he could get away with murder without any consequences. He also wants to terrorize the last dregs of resistance and put an end to war with him as victor. Its been 6 years and even evil dictators get bored of living in bunkers.