Author Topic: The ACA/Obamacare Thread  (Read 3464 times)

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Online El Barto

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Re: The ACA/Obamacare Thread
« Reply #35 on: January 24, 2017, 08:36:29 AM »
Risk pools would be a fine example of repeal without replace. We've already gone that route. Where's the replacement? Moreover, like many things the quality and cost of service would come down to the state. As I've suggested, I doubt I could afford to live in the state I've been in 46 years should we go back to that because Texas simply doesn't spend money on people who need it.
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Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #36 on: January 24, 2017, 08:42:32 AM »
You think when they say "Repeal ACA now and replace it later" that they are going to do a conditional repeal?  Typically repeals are either immediate or have a fixed date.  So assume it's the latter.

Assume repeal passes tomorrow, with a fixed date of 3 years hence. 

They still have to come up with a replacement, which will satisfy enough of the politicians to get approved and also work with providers, insurance companies, and pharmaceutical companies to get their input.  That will take a while.  And with that kind of law, it also won't START immediately; it will have a date in the future that it takes effect.  It may even have phased start dates for various functions like the ACA did.  No reason to think the end date of the ACA and the start date of the new law would coincide, under this example.

The better play would be to leave the ACA alone altogether UNTIL the replacement is ready; that way you could have the end of the ACA and the beginning of the replacement coincide.  But that is NOT what they are talking about right now.

No reason to think it WON'T either, and in fact, Paul Ryan has said as much:  "I clearly think there's a role for the government in health care, no doubt about it," the Wisconsin Republican said.  He added that he supports elements of the health care law -- including that "people with pre-existing conditions, no matter how much money they make," should have access to insurance.
http://www.cnn.com/2017/01/12/politics/paul-ryan-town-hall/index.html

It's a better play TO YOU.   Fair enough, you're entitled to your opinion.  For me, I like the idea of a clock. I like the idea of holding the GOP to the fire.   You've got - to use your time line - three years.  Make it happen.  And if they don't we've got an election coming up to hold them accountable.  I LIKE that we're actually DOING something.  I LIKE that we're actually ACTING on initiatives, and we're promoting accountability.  The "let's wait and see, and let's wait until we're perfect, and let's wait until we... hey, shiny things!" attitude is why we're here.    Interesting that those that are FOR the ACA applaud Obama for not waiting 'until it's perfect!' but are castigating the GOP for the same thing.   For me, I see a difference; I see Obama taking action, then hammering home a flawed bill that many knew wouldn't work, but I see the GOP taking action, and letting the pieces settle into place.  Not acting rashly, but keeping the sense of urgency and accountability that are key. 

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #37 on: January 24, 2017, 08:44:40 AM »
Risk pools would be a fine example of repeal without replace. We've already gone that route. Where's the replacement? Moreover, like many things the quality and cost of service would come down to the state. As I've suggested, I doubt I could afford to live in the state I've been in 46 years should we go back to that because Texas simply doesn't spend money on people who need it.

Well, I can't argue with you anymore, because I don't know.  I just don't know.  But I wouldn't assume - necessarily - that it's the SAME scheme.  I think most people agree that there was a NEED for an ACA, just not the one we got.  So that to me would seem to indicate that we're not going back to the SAME risk-pool structure we had before.   But as I said, I don't know that.  This is now a legit debate. 

Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #38 on: January 24, 2017, 08:45:54 AM »
Stadler, not sure why you like the idea of a clock.  Congress has shown they don't do well with clocks and deadlines.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #39 on: January 24, 2017, 08:58:06 AM »
Stadler, not sure why you like the idea of a clock.  Congress has shown they don't do well with clocks and deadlines.

Because it's not just Congress.  I think AMERICA does AMAZING with clocks.

Tier IV emissions standards (promulgated under Bush, I might add), on the clock, led GE to develop the most efficient, environmentally friendly commercially viable diesel engine ever produced.

We went to the moon on JFK's clock.   

I'm hopeful - and I have some indication that this might happen - that the insurers, long Obama's (unfair) whipping boys, will proactively recognize that change is going to happen and will propose something that is viable, but that answers the legitimate criticisms of the past, including pre-existing conditions, doctor selection, and reduction in costs.   

This isn't going to be solved by our Representatives ONLY.

Online El Barto

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Re: The ACA/Obamacare Thread
« Reply #40 on: January 24, 2017, 09:02:42 AM »
Risk pools would be a fine example of repeal without replace. We've already gone that route. Where's the replacement? Moreover, like many things the quality and cost of service would come down to the state. As I've suggested, I doubt I could afford to live in the state I've been in 46 years should we go back to that because Texas simply doesn't spend money on people who need it.

Well, I can't argue with you anymore, because I don't know.  I just don't know.  But I wouldn't assume - necessarily - that it's the SAME scheme.  I think most people agree that there was a NEED for an ACA, just not the one we got.  So that to me would seem to indicate that we're not going back to the SAME risk-pool structure we had before.   But as I said, I don't know that.  This is now a legit debate.
Well, really the only room for change is in the amount the government is willing to kick in, and for me it won't make much difference. One year I actually missed the cutoff for a generous rate reduction by by $200 annual income. The added money will only go to cover more people, not lower the cost. While Texas was charging me $600+/mo in 2014 Texas dollars for a pretty shitty plan, folks in the hippie states couldn't get covered at all. Sick Californians moved to Mexico to get treatment (how's that for irony). That will likely change with federal subsidies, but if you can't afford it what's the point?


edit: the more recent example of clocks would be the sequester. That didn't work out so well (though I thought it was a brilliant idea).
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Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #41 on: January 24, 2017, 09:07:47 AM »
Stadler, not sure why you like the idea of a clock.  Congress has shown they don't do well with clocks and deadlines.

Because it's not just Congress.  I think AMERICA does AMAZING with clocks.

Tier IV emissions standards (promulgated under Bush, I might add), on the clock, led GE to develop the most efficient, environmentally friendly commercially viable diesel engine ever produced.

We went to the moon on JFK's clock.   

I'm hopeful - and I have some indication that this might happen - that the insurers, long Obama's (unfair) whipping boys, will proactively recognize that change is going to happen and will propose something that is viable, but that answers the legitimate criticisms of the past, including pre-existing conditions, doctor selection, and reduction in costs.   

This isn't going to be solved by our Representatives ONLY.
I certainly hope you are right, but since it definitely won't be solved WITHOUT our Representatives, I am pessimistic.

the more recent example of clocks would be the sequester. That didn't work out so well (though I thought it was a brilliant idea).
That's what I was thinking of.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #42 on: January 24, 2017, 10:46:48 AM »
Risk pools would be a fine example of repeal without replace. We've already gone that route. Where's the replacement? Moreover, like many things the quality and cost of service would come down to the state. As I've suggested, I doubt I could afford to live in the state I've been in 46 years should we go back to that because Texas simply doesn't spend money on people who need it.

Well, I can't argue with you anymore, because I don't know.  I just don't know.  But I wouldn't assume - necessarily - that it's the SAME scheme.  I think most people agree that there was a NEED for an ACA, just not the one we got.  So that to me would seem to indicate that we're not going back to the SAME risk-pool structure we had before.   But as I said, I don't know that.  This is now a legit debate.
Well, really the only room for change is in the amount the government is willing to kick in, and for me it won't make much difference. One year I actually missed the cutoff for a generous rate reduction by by $200 annual income. The added money will only go to cover more people, not lower the cost. While Texas was charging me $600+/mo in 2014 Texas dollars for a pretty shitty plan, folks in the hippie states couldn't get covered at all. Sick Californians moved to Mexico to get treatment (how's that for irony). That will likely change with federal subsidies, but if you can't afford it what's the point?


edit: the more recent example of clocks would be the sequester. That didn't work out so well (though I thought it was a brilliant idea).

If you have that problem this year, I know a guy...   ;)

Offline XeRocks81

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Re: The ACA/Obamacare Thread
« Reply #43 on: January 26, 2017, 09:21:29 PM »
http://www.politico.com/story/2017/01/trump-white-house-obamacare-ads-234245

Folks could still sign up until next tuesday the 31st and be insured through 2017 even if it was repealed, that's better than nothing.  But now they pull the ads advertising it.   I mean this is just spite at this point right?    :censored

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Re: The ACA/Obamacare Thread
« Reply #44 on: January 26, 2017, 10:09:15 PM »
Spite is definitely the point.  Republican controlled states would rather prevent Obama from getting a political victory than insure their own citizens, being that most of them refused to comply with Obamacare's attempted Medicaid expansion despite almost the entire cost being covered.  Which basically means that red states are willing to put up with at least a certain number of increased deaths of their own citizens in order to thwart Obama.
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Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #45 on: January 27, 2017, 07:23:55 AM »
That's offensive.   Seriously.  Implying - actually, not implying, EXPLICITLY stating - that someone wants people dead just because of their political party?   Repulsive. 

Online El Barto

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Re: The ACA/Obamacare Thread
« Reply #46 on: January 27, 2017, 08:12:27 AM »
We weigh the cost/benefit of human life all the time. You're old enough to remember the Pinto. I wouldn't go so far as to say that Texas wants people to die, but Texas certainly determines that X number of increased deaths is a fair price for political or social action (or in this case inaction). In this state, as a childless, single male, I'm ineligible for medicaid under any circumstances. This happens even though the federal government offered to pay the cost for adding me to the dole. Yeah, I have to see it as somewhat spiteful, myself.
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Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #47 on: January 27, 2017, 08:20:01 AM »
That's offensive.   Seriously.  Implying - actually, not implying, EXPLICITLY stating - that someone wants people dead just because of their political party?   Repulsive. 

Yes, it is a repulsive attitude for the republican party to take. In any case, they don't want them dead, the are just ambivalent to the fact that people will die.

Offline Chino

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Re: The ACA/Obamacare Thread
« Reply #48 on: January 27, 2017, 08:24:48 AM »
We weigh the cost/benefit of human life all the time. You're old enough to remember the Pinto. I wouldn't go so far as to say that Texas wants people to die, but Texas certainly determines that X number of increased deaths is a fair price for political or social action (or in this case inaction). In this state, as a childless, single male, I'm ineligible for medicaid under any circumstances. This happens even though the federal government offered to pay the cost for adding me to the dole. Yeah, I have to see it as somewhat spiteful, myself.

I was going to say the same thing about the GM ignition switch problem just a few years ago. Cost benefit analyses showed that paying the inevitable lawsuits for wrongful deaths would have been cheaper than a recall.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #49 on: January 27, 2017, 08:57:55 AM »
That's offensive.   Seriously.  Implying - actually, not implying, EXPLICITLY stating - that someone wants people dead just because of their political party?   Repulsive. 

Yes, it is a repulsive attitude for the republican party to take. In any case, they don't want them dead, the are just ambivalent to the fact that people will die.

That's not what I mean, and you know it.  It's one thing to argue policies and politics, but to resort to ad hominem attacks like that, well, it speaks volumes.    If the argument FOR the coverage was so great and just, there wouldn't be any need to resort to such low tactics.   It's also fear-mongering, since there is absolutely no indication that those outcomes are likely.  It's not as if they STOPPED THE ENROLLMENT.  They halted ADVERTISEMENT, for a program that people already knew existed and in most cases, already started enrolling in.   At some point there has to be SOME personal accountability.   If I want healthcare, if I know where to get it, and simply don't complete the application, that's not on any one politician - Republican or Democrat - but it's on ME.   And it's egregious to attribute that to some morbid "death wish" on the part of politicians whose only crime is to not see things like you do.   

Offline hefdaddy42

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Re: The ACA/Obamacare Thread
« Reply #50 on: January 27, 2017, 10:12:32 AM »
It's NOT a death wish.  It's not WANTING people to die.

It's not really caring if they die or not.  That's a different thing.

Hef is right on all things. Except for when I disagree with him. In which case he's probably still right.

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #51 on: January 27, 2017, 10:19:11 AM »
Same way a drunk driver probably doesn't plan to kill someone when he gets into his pickup to drive home after 10 beers, but that doesn't mean its not a probable outcome of performing that action.

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #52 on: January 27, 2017, 10:24:49 AM »
Yes, it is a repulsive attitude for the republican party to take. In any case, they don't want them dead, the are just ambivalent to the fact that people will die.

It's not really caring if they die or not.  That's a different thing.

Same way a drunk driver probably doesn't plan to kill someone when he gets into his pickup to drive home after 10 beers, but that doesn't mean its not a probable outcome of performing that action.

With all due respect, as a registered Republican, this kinda stuff is offensive. Saying that because of party affiliation I am "ambivalent to the fact that people will die" or "not really caring if they die or not"...

I can tell you for me, that's totally not true. Once again, with respect, you guys are mods here and this seems okay to you?

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #53 on: January 27, 2017, 10:27:54 AM »
When I say "The Republicans", I am referring to the federal legislature, not all members of the party, since they are the ones repealing the laws without a replacement in place.

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #54 on: January 27, 2017, 10:32:32 AM »
When I say Republican, I am referring to the legislature, not all members of the party, since they are the ones repealing the laws without a replacement in place.

Okay, understood, in my mind "Republican party" means everyone in the party, politicians and voters all included. Sorry about that miscommunication.

Separately - my understanding is that they are going to repeal and replace. Not just repeal. Now we can argue the merits of the replacement once announced, the pros and cons, that's all up for debate. But to the best of my knowledge their plan is to have a replacement of some sort.

Offline pogoowner

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Re: The ACA/Obamacare Thread
« Reply #55 on: January 27, 2017, 10:33:39 AM »
To get back to the advertising issue itself, from what I understand, they did not recoup any of the $5 million (I think that was the number) spent for the ACA advertisements. They just canceled them. I don't know how to put a good spin on that.

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #56 on: January 27, 2017, 10:37:11 AM »
Separately - my understanding is that they are going to repeal and replace. Not just repeal. Now we can argue the merits of the replacement once announced, the pros and cons, that's all up for debate. But to the best of my knowledge their plan is to have a replacement of some sort.

That's certainly the official line they have been giving, but given that the house/senate has been trying to repeal obamacare for the last 7 years or so without so much as a peep of what the plan replacing it would be, and given that Trump/Bannon's current strategy seems to boil down to "burn it all", you'll have to forgive me for being skeptical that they plan to replace it with something/anything that would cover more people.

If that turns out to be wrong, I will gladly eat my hat, but until then I can only judge the republican legislature on what they have actually done the last few years, which is attempt to repeal and offer no replacement plan.

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Re: The ACA/Obamacare Thread
« Reply #57 on: January 27, 2017, 10:46:19 AM »
To get back to the advertising issue itself, from what I understand, they did not recoup any of the $5 million (I think that was the number) spent for the ACA advertisements. They just canceled them. I don't know how to put a good spin on that.

This is the key for me. If they were getting the money back it would be one thing, but to not save any money and pull the ads anyway means that you're just doing it to spite Obamacare and you're comfortable with potentially fewer of your constituents having health insurance.

Offline KevShmev

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Re: The ACA/Obamacare Thread
« Reply #58 on: January 27, 2017, 10:46:31 AM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #59 on: January 27, 2017, 10:46:54 AM »
Separately - my understanding is that they are going to repeal and replace. Not just repeal. Now we can argue the merits of the replacement once announced, the pros and cons, that's all up for debate. But to the best of my knowledge their plan is to have a replacement of some sort.

That's certainly the official line they have been giving, but given that the house/senate has been trying to repeal obamacare for the last 7 years or so without so much as a peep of what the plan replacing it would be, and given that Trump/Bannon's current strategy seems to boil down to "burn it all", you'll have to forgive me for being skeptical that they plan to replace it with something/anything that would cover more people.

If that turns out to be wrong, I will gladly eat my hat, but until then I can only judge the republican legislature on what they have actually done the last few years, which is attempt to repeal and offer no replacement plan.

I get that, to a degree, but I believe within the past week or so I've seen two different plans out there... I'll try to look them and get back to you on the details.

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Re: The ACA/Obamacare Thread
« Reply #60 on: January 27, 2017, 10:59:12 AM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.
I don't think it's that they're indifferent to death. I think they simply value deaths more or less than other things. These things will generally turn out to be personal interests. Is it worth a billion dollars to treat one 75 year old woman? What if the woman's your mom? What if she's a convicted criminal?
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Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #61 on: January 27, 2017, 11:04:03 AM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.
I don't think it's that they're indifferent to death. I think they simply value deaths more or less than other things. These things will generally turn out to be personal interests. Is it worth a billion dollars to treat one 75 year old woman? What if the woman's your mom? What if she's a convicted criminal?

Doesn't that make the case that gov. shouldn't be involved in healthcare at all? Then there would be no concern over what gov. officials value more or less than death.

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #62 on: January 27, 2017, 11:45:47 AM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.
I don't think it's that they're indifferent to death. I think they simply value deaths more or less than other things. These things will generally turn out to be personal interests. Is it worth a billion dollars to treat one 75 year old woman? What if the woman's your mom? What if she's a convicted criminal?

Doesn't that make the case that gov. shouldn't be involved in healthcare at all? Then there would be no concern over what gov. officials value more or less than death.

That just means you pass the buck on to private companies who give even less of a shit than the government who live and dies.

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Re: The ACA/Obamacare Thread
« Reply #63 on: January 27, 2017, 11:49:59 AM »
Both sides are guilty on occasion of not caring if people die for their cause.

Some on the right do not care if some lose insurance and get sick, just so they can repeal the ACA.

Some on the left do not care if people die during protests that during violent, because it's for their version of the greater good. 

It's foolish, naive and partisan to think otherwise.
I don't think it's that they're indifferent to death. I think they simply value deaths more or less than other things. These things will generally turn out to be personal interests. Is it worth a billion dollars to treat one 75 year old woman? What if the woman's your mom? What if she's a convicted criminal?

It's just a number to the people doing the math to figure things out.  I don't think anyone wants more people to die, but it's a side effect of trying to find the best way to get healthcare to everyone at an affordable rate.  Doesn't make it OK and it doesn't make it something that people (rep/dem/whatever) want, just the sad reality IMO.

Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #64 on: January 27, 2017, 12:32:00 PM »
It's NOT a death wish.  It's not WANTING people to die.

It's not really caring if they die or not.  That's a different thing.

You're splitting hairs.  It's still something else to accuse someone of not caring if someone dies.   Especially when you're not really talking about policy (the "WHAT") but just the "how".

https://www.washingtonpost.com/politics/behind-closed-doors-republican-lawmakers-fret-about-how-to-repeal-obamacare/2017/01/27/deabdafa-e491-11e6-a547-5fb9411d332c_story.html?hpid=hp_hp-banner-main_goptapes-138pm%3Ahomepage%2Fstory&utm_term=.ae731aa58c91

Republicans.  Doing and saying all the things some of you are saying they don't give a crap about.  Again, it's not as if "political party" is indicative of whether one is human, with human feelings. 

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Re: The ACA/Obamacare Thread
« Reply #65 on: January 27, 2017, 12:35:30 PM »
It's NOT a death wish.  It's not WANTING people to die.

It's not really caring if they die or not.  That's a different thing.

Yeah, I never said anything about them wanting people to die.  I obviously can't prove that.
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Offline Stadler

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Re: The ACA/Obamacare Thread
« Reply #66 on: January 27, 2017, 12:37:09 PM »
When I say "The Republicans", I am referring to the federal legislature, not all members of the party, since they are the ones repealing the laws without a replacement in place.

Again, with the wrong assumptions, if not outright lies. They are REPEALING AND REPLACING.   The first law doesn't go away until the new one is ready to go.   "REPUBLICANS" (whether you mean "legislature" or not; but perhaps you can be more discerning in your terminology so we can follow, because I interpreted it like Mikey) are very mindful of not having the bottom fall out, and they have said so REPEATEDLY.    See my link above.

I don't know how many times they have to say "REPEAL AND REPLACE" before the misconceptions and misstatements will end. 

Offline XJDenton

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Re: The ACA/Obamacare Thread
« Reply #67 on: January 27, 2017, 12:39:07 PM »
They can claim all they they like that they will REPEAL AND REPLACE, until they come up with a concrete replacement plan, all they have as a plan is repeal, and all they have tried to do for the last 7 years is repeal. They've had 7 years to come up with a replacement. Where is it?

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #68 on: January 27, 2017, 12:39:57 PM »
You're splitting hairs.  It's still something else to accuse someone of not caring if someone dies.   Especially when you're not really talking about policy (the "WHAT") but just the "how".

https://www.washingtonpost.com/politics/behind-closed-doors-republican-lawmakers-fret-about-how-to-repeal-obamacare/2017/01/27/deabdafa-e491-11e6-a547-5fb9411d332c_story.html?hpid=hp_hp-banner-main_goptapes-138pm%3Ahomepage%2Fstory&utm_term=.ae731aa58c91

Republicans.  Doing and saying all the things some of you are saying they don't give a crap about.  Again, it's not as if "political party" is indicative of whether one is human, with human feelings.

Good read, thanks for posting.

Offline mikeyd23

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Re: The ACA/Obamacare Thread
« Reply #69 on: January 27, 2017, 12:42:04 PM »
They can claim all they they like that they will REPEAL AND REPLACE, until they come up with a concrete replacement plan, all they have as a plan is repeal, and all they have tried to do for the last 7 years is repeal.

As I mentioned earlier, they have plans out there, just nothing finalized or decided at this point. Here is a quick read to touch on a couple:

http://www.npr.org/2017/01/26/511675435/republicans-have-plans-to-replace-obamacare-now-they-need-to-agree-on-one