“Only a few years ago, the party was united behind three reforms that are consistent with individual empowerment and limited government: (1) a universal health refund that transfers all government tax and spending subsidies to ordinary citizens each year with no strings attached other than the requirement that it be used for health care, (2) a flexible Health Savings Account that allows people to manage some of their own health care dollars and (3) pre-existing condition protection for people who lose their insurance because of government policies.
For well over a decade House Speaker Paul Ryan (R-WI) was a steadfast supporter of all three ideas, including replacing tax and spending subsidies for health care and health insurance with a universal tax credit. John McCain ran on these ideas in the 2008 election. The legislative embodiment of McCain’s plan was the Patients Choice Act, which Ryan cosponsored in 2009 along with Devin Nunes (R– CA) in the House and Tom Coburn (R–OK) and Richard Burr (R–NC) in the Senate.”
“The American Health Care Act (AHCA), proposed by the House leadership, was not about health care. It was about taxes. Over and over, Ryan said he needed to do health reform before tax reform. In particular, he said he needed to reduce Obamacare taxes by $1 trillion and to reduce spending by more than $1 trillion.As noted, a tax cut tied to health care is part of good health reform. But the Ryan tax cut wasn’t tied to health care. It consisted of repealing the very revenues that were funding Obamacare. (See below.) Since the tax cut took money out of the system, the spending cuts paired with it also removed money from the system.”
Remember how the Democrats did it. They created Obamacare behind closed doors. There was no real pubic vetting. No real attempt to make sure the pieces fit together in a sensible way. And no possibility of a single vote from the other party.
The House Republican Leadership seems enamored of that approach. The latest GOP replacement plan was announced last Monday after weeks of secrecy. The two relevant committees began their markup two days later – with no hearings, no vetting, no CBO score and no amendments.
It does not lower costs. It insures many fewer people. It does not stop the race to the bottom in the exchanges that is so harmful to the chronically ill.Instead, the GOP plan seems designed to make the individual market work better. That means helping Obamacare work better. For all the apparent differences, the Republicans are just as committed to the managed competition model as the Democrats were.
Great tutorial that can get you up-to-speed on the budget and how it won’t balance under current trajectory. Senator Paul explains a simple way to balance and control the debt.
That’s the argument that British economist Andrew Lilico made recently in an interview with Vox’s Timothy Lee—that while Britain has gained from being part of the EU, both entities will be better off apart, and that the split, while upsetting to markets in the short term, will ultimately pave the way toward long-term gains for both, with the EU becoming stronger and more unified in a way that it simply couldn’t with Britain attached. Britain, in this thinking, helped set EU culture early on, but was simply too independent to ever fully integrate with the continent. Post-Brexit, basically, the EU is free to become the United States of Europe.
I’m a little less confident that this scenario will play out. Britain’s exit from the EU is just as likely to lead to more sovereign squabbling and a further breakdown of the EU. But ultimately even that might be better in the long run, as the EU as it stands is a deeply dysfunctional governing body that has consistently proven itself unable to effectively respond to the challenges it faces. The design of the EU is inherently awkward: Its monetary union is undercut by its lack of a fiscal union, and its attempts to maintain some level of national sovereignty are undercut by its power imbalances andanti-democratic elements. The structure is inherently unstable.
Regardless of which way it goes, the Brexit vote is likely to spur the EU to take action and move beyond its current unstable equilibrium. It’s as clear a sign as any that the EU can’t go on doing what it’s been doing. It’s a wake up call, basically. So while there are certainly risks to a dramatic move like this, that’s a good thing overall.
In the meantime, Britain is probably better off no matter what. If the EU moves toward becoming the smoothly functioning super-state that Lilico hopes for, then Britain will have helped make that possible. And if the EU continues in its dysfunction, or breaks up further, Britain will have extricated itself, protecting its own interests.
Brexit might spur U.K. reforms.
You can take this to the bank. Every innovation in the production of every good or service – anything that lowers costs or increases quality – originates on the supply side of the market. There has never been a successful innovation that originated on the demand side.
This principle applies to health care in spades. For as long as I have been in health policy – more than 30 years – I have been dealing with non-doctors who have a deep, abiding desire to tell doctors what to do. Yet I don’t know of any example anywhere in the world where this approach has ever worked.
If the definition of insanity is repeating the same thing over and over again and each time expecting a different result then “insanity” is the appropriate word here. The Obama administration has spent millions of dollars on pilot programs and demonstration projects in a fruitless attempt to discover how to better practice medicine. It has spent millions more trying to herd Medicare patients into Accountable Care Organizations – super HMOs with financial incentives to hit quality measures. That hasn’t worked either.
Becoming a more likable leader is completely under your control, and it’s a matter of emotional intelligence (EQ). Unlike innate, fixed characteristics, such as your intelligence (IQ), EQ is a flexible skill that you can improve with effort. What follows are 10 key behaviors that emotionally intelligent leaders engage in that make them very likable.
I maintain that the same old stakeholders have been controlling things for too long, giving us a system looks like it was brokered by Bernie Madoff; full of cost-shifting, complex contracts, reimbursement codes and formula, tax-favored treatment of businesses over individuals, perpetual premium increases and a general lack of price transparency.
Meanwhile, we continue to go round and round in partisan debate: Is healthcare a right or a commodity? Single payer vs insurance model; block grants vs federal control of Medicaid… and the list to argue about is nearly endless. But that list has been predetermined by self-appointed policy experts and politicians who forced these talking points into the public debate, designed to polarize us and make us choose sides while nothing gets done to solve the problem. So what about options that are not on the approved debate list? Maybe we should examine them closer.
I think we have firmly established that more of the same, which includes the colossal tax-payer subsidization of the third-party payer industry referred to as ObamaCare, is not the solution. And let’s agree that the solution(s) doesn’t necessarily have to line up perfectly with all our preconceived ideas or philosophies of healthcare. It just has to work.
Read the entire article via A New Market Is Rising | Robert Nelson, MD | LinkedIn.