the coherent conservative position is that cheaper plans with higher deductibles are a very good thing, because they’re much closer to what insurance ought to be — and the more they proliferate, the cheaper health care will ultimately be for everyone.
.. spending, as of 2014, just 5 percent of G.D.P. on health care. (By comparison, a typical Western European country that year spent around 10 percent; the United States spent 17 percent.)
.. Singaporeans do not spend money voluntarily saved in health-savings accounts. Under their Medisave program, they spend money saved in mandatory health-savings accounts, to which employers contribute as well. Second, their catastrophic insurance doesn’t come from a bevy of competing health insurance companies, but from a government-run single-payer system, MediShield. And then the government maintains a further safety net, Medifund, for patients who can’t cover their bills, while topping off Medisave accounts for poorer, older Singaporeans
.. By forcing its citizens to save and manage their own spending
.. I just hope those principles are a comfort to them when the next wave of liberalism delivers us to a much more plausible health insurance destination than Singapore: Straightforward single-payer, in the form of Medicaid for almost all.
Could ‘RyanCare’ ruin President Trump?
President Trump has repeatedly thrown his support behind the GOP plan to replace ObamaCare and apparently has been negotiating with opposing lawmakers. But should he actually be wary of the plan?
My highest priority is protecting vulnerable Americans.
Why Paul Ryan needs Donald Trump so badly
This proposal was crafted trying to thread a needle between two competing corners of the House GOP Conference: the far-right blockade and a much larger, less vocal crowd from states where their governors accepted the expanded Medicaid provision in the 2010 ACA.
Some Freedom Caucus folks have been strenuously opposed to the proposed tax credits for purchasing insurance, saying it’s a new form of entitlement, and many want to more quickly phase out the Medicaid expansion.
.. If Trump ever fully leans into this legislation, giving it the full-forced endorsement that he’s proven capable of on other issues, Ryan and House GOP leaders believe that the conservative opposition will dissolve quickly.
.. not once but twice he said he wouldn’t sign any bill that “didn’t take care of our people.”
.. Some politicians let bygones be bygones if they win ([Chuck] Schumer is very much like this; he wins, there’s no grudge held, it’s water under the bridge). Trump strikes me as someone who holds grudges, but I’m not certain.
.. But if this disintegrates, if there’s no repeal of Obamacare, it’s bad, very bad, for both men – and what it does to their relationship for the next few years.
.. most House Republicans are more afraid of not approving a bill to repeal Obamacare, any bill to repeal Obamacare, regardless of its fate in the Senate, than to simply do nothing.
.. The way the districts are drawn, the way the funding mechanisms of campaigns now work, the activism of the two bases of the parties – it all pushes members to the extreme. They now act almost entirely at the behest of their base rather than what they believe is the right thing for the country.
.. McConnell has to come up with his own bill that will tilt more friendly to the [Rob]Portman/[Shelley Moore] Capito crowd, which might upset Ted Cruz and Mike Lee but I’m still not certain that in the end Cruz is willing to be the guy who blocks Donald Trump’s first big initiative... I think the two worst character traits in today’s Congress are fear and contentment... You just have to be willing to work hard, willing to go home as much as possible to explain yourself and to run a really disciplined, well-funded campaign if you get a primary. Folks like Lamar Alexander, Lindsey Graham, Tom Cole, Jack Reed, Frank Pallone — these are are all people who’ve done more than their fair share of bipartisan deals in the Senate and House. Some have faced down tough primary elections.They’re all still here.
.. The “contentment” character trait is that too many lawmakers are content with what they have: a tiny fiefdom. They’d rather not rock the boat because that means they might have to work really hard to win re-election.
.. The biggest change that I’ve seen over those years is the shrinking number of leaders on Capitol Hill; not the actual elected leaders, but the men and women in the rank-and-file who commanded the policy brigade and through the sheer force of their character made themselves players. They weren’t afraid and they weren’t content.
Trumpcare’s Lonely, and Seedy, Supporter
Some of the only outside praise has come from the chief executive of Anthem, the country’s second largest insurer.
.. one of the bill’s few high-profile fans may not even support it on the merits. Instead, Anthem appears to be providing political cover to the administration at the same time that company officials are lobbying the administration for a favorable decision on another matter.
.. Anthem’s best remaining hope for the deal is probably to persuade the Trump administration to take a different view of the merger and unblock it.
.. Rather, Swedish lauded a few provisions (which would clearly help Anthem’s bottom line) and offered enough kind words that the White House could claim Anthem supported the bill.
.. More significantly, President Trump and Tom Price, the Health and Human Services secretary, granted Swedish a private meeting this week. At it, Swedish lobbied for changes to the bill that would benefit Anthem
.. Aetna responded with a bold attempt at quid pro quo. It threatened administration officials that it would withdraw from Obamacare insurance markets unless the merger was approved
.. Aetna executives tried to keep their conversations about the threats to phone calls rather than email “to avoid leaving a paper trail,” as a federal judge later found.