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House declares war on Massachusetts, other states

The House vote to gut much of the Affordable Care Act will cost Massachusetts more than a billion dollars a year, Gov. Baker says. After the vote, Baker, like the majority of the House, a Republican, vowed to fight the measure in the Senate.

The proposal would also effectively diminish a woman's right to abortion by banning insurance companies that offer insurance through the state health connector from covering abortion and would block MassHealth members from getting care at Planned Parenthood. And even people who get insurance through work could be screwed, because the law would let insurers offer plans to companies with operations in multiple states that are based on the one with the worst (for consumers) plans.

The measure now goes to the Senate.

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Imagine living in a country so awful that they would let thousands die or go bankrupt every year just so trust fund brats don't have to pay taxes? Wait, no need to imagine.

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People in Massachusetts talk big, but they will freak out if you suggest raising their taxes. Including the "Progressives".
Forget the country, you're living in a state that does the same thing.

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I'm all for my taxes being raised. More than happy to pay more for schools (and I have no kids), parks, my garbage being picked up, infrastructure, etc.

What should happen is that our state get a better return on our federal tax dollars that we pay rather than the shit red states that hate us but love our money.

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Give everyone health insurance, increased taxation on gas/oil, subsidize solar/wind/electric cars, require a living wage instead of a minimum wage, increase mass transit reach and quality, delete the "charter school" experiment and reinvest in public schooling, and investigate the impact of a guaranteed income.

Do all that and if the end result is I pay more per month, so be it. I would be getting back so much more AND, better yet, so would everyone else, especially those that need it.

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but it's a very strong indication of why Single Payer with Universal Healthcare/Medicare for all Americans is really the best, and only way to go! If that had been in there, people wouldn't now be in such danger of either dying or being permanently incapacitated by serious illness or injury.

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It will be interesting to see how a governor fights in the Senate.

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Many have questioned why Baker didn't stand up at some of the earlier protests. This is why. He's the only link we have to Washington. A Republican gov has LOTS of pull in DC, especially with his popularity. Technically, no. But behind the scenes he can do more than Markey and Warren combined times two.

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So you imagine that our Gov is going to go convince a Senator or two from some other state, but that is not something our actual Senators could do? Because Charlie is some kinda rock stah or something?

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I was reminded this was being done under reconciliation - requiring 60 votes - and there is no nuclear option of reducing it to 50 - at least for now. It also needs to be shown to be "revenue neutral" - actually a test this might pass because it's such a crappy law from everything I've read - unlike the tax reform package which won't come close to passing the revenue neutral rule without absurd assumptions.

As for Senators - Warren has a tough time getting along with Democrats - no way she convinces even a moderate Republican of anything. Markey can at least probably get a Republican to take his phone calls.

I can easily see Baker getting on the phone with another Republican governor (there are like 35 of them) that might see eye to eye - who then talks to his Republican Senator - or maybe it's a conference call - and getting everyone to agree. Charlie's a smart guy - and may end up a candidate for President in 2020 - people will take his calls and actually listen to him - and there's more than one way to get to a Senator than just picking up a phone and calling directly.

Again - if necessary - and it probably won't be.

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...pleading, over the phone, with a governor from some other state that if Obamacare is dead his reelection chances die with it.

I can see it.

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Step 1: Don't vote for either candidate in the general election
Step 2: Refuse to say that he's pro-Trump after the election
Step 3: Sit on his hands during the Senate's failed attempts to strip millions of people of their health insurance
Step 4: Doot doot doot, just hanging' out in the governor's mansion while Trump repeatedly shits the bed
Step 5: Aha! Now that the House has passed the same odious piece of shit that the senate rejected a month ago, time to spring into action!

I am also curious as to how a Republican governor from a state that went +30 to Hilary is likely to have any sway in this banana republic federal government.

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Are you kidding? Republicans would love to figure out how he got elected and bottle it.

You'll also never hear about this until well after the fact. Lots of behind the scenes stuff.

And as noted, only if somehow they can get something that can get close to 60 votes by which point it would have to be a pretty good bill anyway.

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He's not a good "Christian" bent on killing people in droves because they must have sinned in utero or something, and he doesn't carry the proper hatred of disability and disabled "god hates them" children in particular.

He's GOP, but he remembers what those letters stand for. They don't want him. They don't want to "bottle" what he's got because they cannot control him.

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We'll just deduct it from our federal tax contributions.

Let's see how red state Trump voters feel about federal subsidies, when Massachusetts money stops subsidizing red states.

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When it is them receiving it. Just don't let it go to those that actually need it. Most red states are straight up welfare states propped up by the coastal elites' taxes.

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Yup, and when that is pointed out to conservatives, they respond with "keep on working you liberal, keep that money coming"

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Ok. How does that work exactly?

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We'll just deduct it from our federal tax contributions.

Really? I'm not a tax accountant, so maybe you can point me to where that line item is in all the IRS forms. There's a possibility this might work out for me, because I'm employed and I pay taxes. Of course, for someone who isn't employed or who earns shit wages, if you deduct the cost of health insurance from their taxes, you'd get negative numbers, so there goes that idea.

I am all in favor of pointing out, loudly and often, how states like Massachusetts contribute more to the federal government than we get back, all while being at the shit end of the stick in terms of national priorities. But you don't get to simply say "fiddle dee dee we just won't pay our taxes" -- not without some heavy consequences. Tax resistance is a thing, people have done it, but you pay up front for that battle and you're not likely to win it. You'd need much more widespread tax resistance, and for that you need a mass movement. So, if you've questioned the usefulness of all those marches, this is part of what they're accomplishing: creating that mass movement. Is it slow? Yes. Is it messy? Yes. But I don't know another way to do it.

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Lets see them arrest an entire state when our local IRS office allows us to stop the deductions.

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Still not getting how this works. The local IRS office needs to go rogue is what you are saying?

I do my taxes with tax software. I don't think it touches the local IRS office unless I were to get flagged for an audit.

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I was trying to make a statement about hypocritical Trump voters screwing over everyone, on Massachusetts's dime.

I'm gravely concerned about the AHCA move, and that working class Trump supporters still don't seem to understand that the Trump administration is against their interests.

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Declares war on the poor, poor-adjacent, middle class, and anyone currently sick or injured or susceptible to becoming sick or injured sometime in the future.

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to crash the healthcare system in order to make single payer more palatable to the general public. They, including those who engineered the Affordable Healthcare Act, also obviously don't give a fuk who gets hurt by their machinations.

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TPTB? Like these people?

Yeah, they're all about single payer, you bet.

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It's unfortunate for this to happen. Too bad they don't ditch the mortgage interest deduction and increase the FICA cap, I bet that would help the Treasury and offset Obamacare costs.

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I like the mortgage interest deduction .

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If your objective is to put more money in the Treasury s pocket. Personally I'd like to see entitlements reduced to a more affordable level and the COST of health care reduced. That's far more sustainable than the death spiral governments of all levels are in.

We should have universal coverage. The debate we need to have is do you go with single payer which likely means a totally government run system or a true insurance system with shared risks and costs.

Pros and cons to both.

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If your objective is to put more money in the Treasury s pocket. Personally I'd like to see entitlements reduced to a more affordable level and the COST of health care reduced. That's far more sustainable than the death spiral governments of all levels are in.

We should have universal coverage. The debate we need to have is do you go with single payer which likely means a totally government run system or a true insurance system with shared risks and costs.

Pros and cons to both.

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If older people would die off faster then there would be less demand on Social Security.

As absurd and horrid as that argument would be I sometimes wonder if that is what's going on in the heads of conservatives and Republicans? In all the strife and shouting about health care hardly a peep or tweet about Social Security (some peeps but not the attention it needs). Why? Because supposedly for Social Security to continue with the benefits that are currently provided something has to change. What? FICA taxes for one. Either increase them across the board and/or raise the income cap. I am sure that folks who voted for Trump who earn more than the income cap would have cows if they had to pay more.

As for Trump's promises of lowering taxes (and bankrupting government?) he and Congress can not do that and raise FICA taxes.

So what gives? Letting people die earlier. Maybe this theory as the reason for gutting health care is not so far off. The people running Congress come across as folks who have ZERO regard for constituents. They want their constituents votes, pay lip service to non-controverial issues but hide when constituents demand answers to why they are screwing with constituents health care.

So maybe elected officials really see voters as just numbers. Not as individuals with families and communities. But just as numbers. Maybe that is why Liz Warren is so despised in Republican and conservative circles. Because she doesn't pay lip service to strengthening the middle class. One of her most important projects before being elected was the Consumer Finance Protection Bureau. Something that bank and financial executives don't want because when working that is a watchdog over their practices. Wells Fargo being the current Example A.

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I think you're giving the House and Trump too much credit, thinking they have a long term game plan all thought out. I don't think they've thought past "how do we line our pockets more, while still remaining popular with our core constituents?"

There's so much money in politics, it's absurd. Until we do something about that, politicians on both sides of the aisle basically can't be trusted to work in the best interest of the people. They are literally being paid to think in the best interest of big pharma, or tobacco, or banks. It's their job.

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First, highly doubt this passes the Senate. But that said, we all get the politicians we deserve, whether you voted for Trump and his band of merry men or not. We, and the press should've called out the fact that Sanders, sand super delegates had more support than Hillary. Also should've called Trump out on his BS instead of just assuming he wouldn't win. Obama could've and should've spoke up more. SO we're all left with what we deserve for not being more proactive and truthful in our politics.

Secondly, any non-affluent person who votes republican is an idiot. They don't give two you know whats about any of you. The republican party as currently constituted is a joke and totally available to the highest bidder.

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people that disagree with your political perspective are idiots

thats good how long did that one take you

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I think people who subscribe to any one set of ideas is an idiot. I'm a registered (I) who is fiscally conservative, but socially liberal. In general I think adults should be allowed to do whatever they want so long as it doesn't impact anyone else. I think the federals government's job should be to provide healthcare, defense, and protect our natural land from corporations that would poison a river if it meant higher profits for them and their shareholders.

But yes I also think poor people who vote republican are especially stupid.

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How the fuck do we deserve all these hateful Sharia Law crackers that we don't vote for, who come from districts that carry more weight per person in the presidential election?

What's your "preexisting condition"?

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1. Health care is neither a right nor a privilege; it’s a commodity. Worse, it’s a finite commodity. There are only so many doctors, so many hospitals, and so much money, and there are limits to how much these things can be expanded. That’s why no health-care system, outside Bernie Sanders’s fantasies, provides unlimited care to everyone.

2. Coverage is not access. Democrats like to pretend that giving everyone a piece of paper called insurance guarantees them access to the care they need. For example, take Medicaid, which is responsible for more than half the increase in coverage under Obamacare. Nearly a third of primary-care physicians won’t accept Medicaid patients. And when doctors do see Medicaid patients, they tend to be slower in granting appointments. Moreover, for the working poor, seeing doctors during normal office hours can be problematic. Perhaps that’s why Medicaid patients continue to use emergency rooms for routine care at a disproportionate rate.

3. The uninsurable are uninsurable. Let us remember that the definition of “pre-existing condition” is: someone who is already sick. It’s a little like driving your car into a tree and then trying to retroactively buy auto insurance. It won’t work. Insurance is the business of spreading risk. But for someone who, say, has cancer, there’s no risk to spread, just cost. That’s not insurance, it’s paying for health care. Obamacare tried to square this circle by mandating that young and healthy people buy insurance to offset the cost of providing care to those already sick. It turns out that didn’t work. Not enough healthy people signed up to pay for the influx of sick people. All of this forced more healthy people out of the insurance pool and threatened an adverse-selection death spiral.

Republican proposals to keep the popular pre-existing-condition protections while jettisoning the mandate for coverage is only going to make the adverse-selection problem worse.

4. Medicare is not a success. Faced with the wreckage of Obamacare, Democrats are increasingly embracing the once controversial idea of “Medicare for all.” Most of them would start slowly, with a Trojan-horse “public option,” a taxpayer-subsidized plan that would undercut private insurance, but the result would still be a government-run national health-care plan based on Medicare. Medicare is undoubtedly popular, especially with its beneficiaries. It should be. The average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits. Jackpot! But that disparity is one of the reasons why Medicare is running some $58 trillion in the red, after totaling all projected future liabilities. About 15 percent of doctors don’t accept Medicare, and as many as a third limit the number of Medicare patients that they will treat.

5. No, we didn’t have a “free market” health-care system before Obamacare. Suggest free-market reforms to our health-care system and critics will inevitably suggest that you want to go back to the flawed system we had before Obamacare. But that system had little to do with a free market. Nearly all health care was subsidized in some way, either directly or indirectly. Actual health-care consumers paid barely 13 cents out of each dollar spent on health care, while the government directly paid for more than half of all health-care spending. This third-party and even fourth-party payment mechanism insulated consumers from the cost of their health-care choices and drove up both spending and prices.

6. You are never going to make everyone happy. Obamacare is unpopular. The GOP replacement was unpopular. Single-payer in unpopular. In fact, one searches in vain for a health-care reform that voters will love.

Americans want widely contradictory things from health-care reform. They want the highest-quality care for everyone, with no wait, from the doctor of their choice. And they want it as cheap as possible, preferably for free. At the same time doctors, trial lawyers, hospitals, insurers, pharmaceutical companies, and government bureaucrats are all trying to protect their fiefdoms, hold onto their gains, and shift costs to others. There is simply no way to satisfy all these special interests and produce a health-care plan that will be hugely popular.

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straight from the Heritage Foundation, I see. I'm at work, so I can't give this the ten thousand words of mockery it deserves, but I'll give it the ol' college try.

Health care is neither a right nor a privilege; it’s a commodity.

True, if you're an amoral sociopath or a contemporary conservative Republican (but I repeat myself). If you have ever looked at your fellow human beings with greater respect than a kid frying ants under a magnifying glass, you'd be so appalled by the previous statement that you'd be ashamed to express it publicly, because you're actually calling for misery and death among people who aren't independently wealthy. Also, if you're in literally any other first-world industrialized democracy in the world, single-payer healthcare of some sort has been the standard for between ten and sixty years, is universal, more effective, and less expensive than in the United States.

Coverage is not access. Democrats like to pretend that giving everyone a piece of paper called insurance guarantees them access to the care they need. For example, take Medicaid, which is responsible for more than half the increase in coverage under Obamacare. Nearly a third of primary-care physicians won’t accept Medicaid patients.

OK, so let's fix Medicaid, or revoke the medical licenses of practitioners who won't accept Medicaid, because they're part of the aforementioned bloc of amoral sociopaths.

But for someone who, say, has cancer, there’s no risk to spread, just cost. That’s not insurance, it’s paying for health care.

This is the dumbest thing I've read all day, and I just finished up reading the comments on the Globe's coverage of racist baseball fans. When you force everyone to carry coverage, you spread the risk and the cost over a large pool of people, such that the cost of a couple of cancer patients gets absorbed by the relatively healthy remainder of the pool. Every attempt to paint this reality as something else is an effort by aforementioned conservative Republicans to convince you that you're paying for freeloaders, when in fact you are part of a risk pool that is structured exactly the same way as homeowners' or auto insurance. Catastrophic costs are always a risk, and you control them by enforcing mandatory coverage. The closes thing we have to "mandatory coverage" in the American system of government is the individual mandate, which just had the rug pulled out from under it by a bunch of white guys who played the Rocky theme and drank beers to celebrate condemning tens of thousands of Americans to slow and painful deaths.

Medicare is not a success. Faced with the wreckage of Obamacare, Democrats are increasingly embracing the once controversial idea of “Medicare for all.” Most of them would start slowly, with a Trojan-horse “public option,” a taxpayer-subsidized plan that would undercut private insurance, but the result would still be a government-run national health-care plan based on Medicare. Medicare is undoubtedly popular, especially with its beneficiaries. It should be. The average two-earner couple pays about $150,000 over their lifetime in Medicare taxes and premiums, while collecting almost $450,000 in benefits. Jackpot! But that disparity is one of the reasons why Medicare is running some $58 trillion in the red, after totaling all projected future liabilities. About 15 percent of doctors don’t accept Medicare, and as many as a third limit the number of Medicare patients that they will treat.

Excuse any typos here, as my eyes have just rolled so far back in my head that I fear I may be seeing double for the rest of the day. The "wreckage of Obamacare," as quantified by a 50% drop in bankruptcy filings since the ACA passed, along with improved health care outcomes along every measurable axis in existence, is indeed a positive indicator that a modified system of universal Medicare would be a successful approach. The cost controls that it permits (see: every other industrialized first-world democracy in the world, which pays an average of 30-70% less per person in total healthcare costs despite supplying universal coverage) would probably more than pay for the program's expansion, but on the offchance that it didn't, then we should raise the Medicare tax we all pay, and use the tens of trillions of dollars in health care premiums we save every year to absorb the extra 1% tax hike. Or we could pay for it by raising the upper tax bracket back to where it was in the halcyon days of the 1950's, when men were men, economic growth was unprecedented, and you paid 90% of every dollar past the first million to the tax man.

No, we didn’t have a “free market” health-care system before Obamacare. Suggest free-market reforms to our health-care system and critics will inevitably suggest that you want to go back to the flawed system we had before Obamacare.

No one is suggesting a free-market solution to health care. Free-market solutions lead to health insurance company executives living in giant houses while poor people die of preventable diseases.

Actual health-care consumers paid barely 13 cents out of each dollar spent on health care, while the government directly paid for more than half of all health-care spending.

I'll bet you a Galway chicken dinner that that number is horseshit, because it's primarily private businesses who pay those subsidies, but sure, let's assume it's true. Where do you think the government is getting the money to subsidize those costs? (Hint: think "April 15th") Let's bump it to 100%, and make it single-payer.

You are never going to make everyone happy. Obamacare is unpopular.

[citation needed]

The GOP replacement was unpopular.

Who would have guessed that cutting off access to 24 million of the poorest, sickest people in the country would be unpopular? I for one am shocked, SHOCKED

Single-payer in unpopular.

I'm beginning to wonder if you even understand what the words you're using mean.

In fact, one searches in vain for a health-care reform that voters will love.

Ah, yes, the old "we can't make every last person, including the amoral sociopaths who would happily leave their grandma out to starve in the cold if it allowed them to pay $100 less in taxes a year,happy, so we'll have to keep looking until we find something we can all agree on." I'd usually give this a more thorough dissection, but I have a 23-day-old infant at home and haven't slept in weeks, so I will leave this at "stop concern trolling, the enemy of the perfect is not the good, we have a reasonably well-functioning system in place in the ACA, and a bill that just passed the house which is wildly, toxically unpopular among every demographic aside from insurance execs and GOP senators who appear to actually derive sexual pleasure from fucking over poor people."

Americans want widely contradictory things from health-care reform.

No they don't.

They want the highest-quality care for everyone, with no wait, from the doctor of their choice. And they want it as cheap as possible, preferably for free.

Yes, that would be nice.,

At the same time doctors, trial lawyers, hospitals, insurers, pharmaceutical companies, and government bureaucrats are all trying to protect their fiefdoms, hold onto their gains, and shift costs to others.

Fuck them and their rent-seeking selves in the ear. We out number them 100-to-1, and they should be worried about mobs with pitchforks.

There is simply no way to satisfy all these special interests and produce a health-care plan that will be hugely popular.

Except, once again, for every other country in the world that just magically happened to stumble upon a functioning system of single-payer, government-backed health care that produces better outcomes along every measurable axis, costs less, and has higher approval ratings than the American system.

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...if they won't treat you for free?

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The debate on the debate.

Universal coverage is the goal - that I think goes without question (save in the small minds of house Republicans. sounds like the Senate is going to throw this in the trash where it belongs and start over).

The debate is no longer universal coverage or not - it's how we pay for it - and you and CCD hit it on the head. Do we go with single payer (simple and cheap because government caps the price)? Or do we go with some form of insurance which at some level involves consumer choices through co-pays deductibles etc. (which is part of the problem now - the whole system is such an expensive mess - the consumer often can't make an informed choice).

Even before Obamacare we had universal coverage - we all had private, medicare, Medicaid or VA. Or we chose to "save" the money and self-insure. The main problem was the self insurers - who to this day get ripped off due to overcharges and in severe cases have to go broke paying for care.

That's what we did right in Mass and the country screwed up with Obamacare - Mass focused on the uninsured - Obamacare tried to fix problems that weren't problems - with hefty taxes to pay for a lot of it. (however, as a wealthier, highly insured state - we had some natural advantages over the rest of the country which is part of what makes it so difficult nationally).

What the Republicans need to do is get back to what's wrong with Obamacare - complexity and high costs (which you cite). There are advantages to our system (for one - like it or not medical care is a commodity - your doctors and nurses aren't the Sisters of Mercy and high pay attracts really smart talented people - including two of my nieces - they're good people - but they're not going to work for peanuts like they might make in a single payer country. As much as they like their chosen fields - they aren't spending years in school to eat peanuts).

I'll pin some hope on the Senate - which will need a handful of Dems to go along to get it through at least on this pass. But we need to settle the issue of single payer v. insurance once and for all. they look nothing like each other (although a hybrid system like we have now is still possible).

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Seriously, thank you for taking the time to write and post that. You said everything I'd like to say much better than I could ever hope to say it.

You should run for office.

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Once you step off that soap box. why don't tell us idiots how you'd fix 1/6th of our economy. Clearly you're the smartest guy, let's hear your solutions. Sure its easy to "mock" the Heritage Fountain as you're clearly brilliant compared to those blokes. Bottom line is: Obamacare is a failing unless the goal is single-payer. It has done nothing geniuses like Jonathan Gruber and Obama suggested it would. Then again, as Obama stated the goal was to destroy the Health Care system so single-payer was the only option. Sorry if I struggle to believe a bunch of bureaucrats and elected officials could actually run health care/insurance efficient and effectively...

You seem to be neglecting that the other countries with single-payer government run(yikes that terrifying) healthcare are a fraction of the size of the US. Example: Canada? 35 million people. How much more in taxes are YOU willing to pay? Be honest, I know that will be difficult to answer.

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SINGLE PAYER IS THE ONLY VIABLE OPTION

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As a healthcare executive, I live and breath the policies and finances surrounding the American Care Act (ACA). I can tell you emphatically that the ACA, otherwise called Obama Care, is not failing. This fabrication was coined and often repeated during the 2016 election cycle as a way of discrediting the program, which the Republican Party put forth as their plan after Bill Clinton left office. In fact, by 2016 the ACA was actually in better shape than it was in prior years. Predictions also show that premium costs will stabilize in 2017 and there was nothing so far this year to contradict this prediction until the House voted on their version, the AHCA (American Health Care Act).

Does/did the ACA have problems? Yes, but so do a number of other government programs. These are called "unintended consequences." Rather, and this would be the prudent and cost effective thing to do to use Republican language, would be for the Republican party to expend their enormous energy and clout to fix those issues so that we can move forward and create a truly world class health system to rival that of other countries.

As the person you are responding to so eloquently put it, our healthcare system's outcomes rank lower than almost every other industrialized nations and at much higher cost. This is well documented and the data is available on the internet in a number of forums, the United Nations being one of them.

The only solution is a single payer system like that of Canada, the UK, and other industrialized countries. But to have an efficient one payer system, every citizen must participate. In fact, President Trump just yesterday commended the Australian Prime Minister for his country's healthcare system -- Australia's system is notably single payer. Unfortunately, the US wants the best healthcare system money can buy but they aren't willing to pay for it. Until that changes, the US will continue to have a system that is cobbled together and inefficient with ever rising costs.

The plan that was just passed by the US House of Representatives will do nothing to give ALL Americans a workable healthcare solution because it fundamentally treats patients unequally -- the ailing pay higher premiums while the healthy pay lower premiums or don't participate at all, which means that risk isn't distributed evenly across all system.

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Quite the twitter account ya got going there @sherwoodhughes

Wow , talk about venemous haters!

I disagree with a lot of GOP stands, but I physically couldn't hold up a brush as broad as the one you paint with.

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