Republicans gotta get something done.

First they have to deal with Obamacare.  Nobody has ever figured out just what Obamacare is doing and what it is gonna cost.  The health insurers are dropping Obamacare as fast as the can after loosing barrels of money.  Right now it looks like Obamacare promises taxpayer funded health insurance for everyone who doesn't have health insurance from their employer or is 65 years old and hence eligible for Medicare.  Nobody has ever published an estimate of what Obamacare is gonna cost.  A reasonable guess is it will cost as much as Medicare.  There are more people without employer health insurance than there are people over 65.  Since they are younger than 65 they ought to be in better health.   Any way you slice it, Obamacare is a black hole down which we toss money.  A lot of money.
  To do tax reform, we have to get a handle on Obamacare costs.  Unless we at least know what the taxpayers have to fund, you cannot do any tax cutting.  And every one agrees that taxes are too damn complicated, too damn high,  and too unfair.  If tax reform doesn't happen, there will be a LOT of unhappy campers for the 2018 by election.  Might be enough for the Republicans to loose control of the house or the Senate, or both.
   It's do or die time for the Republicans.  They have to reform Obamacare.  They have to do tax reform.  If they don't,  they are gonna get clobbered in 2018.  

Why the Republicans haven't announced a "replace" plan.

It's due out this morning according to the TV.  Democrats have been sniping at it, claiming that the Republicans should have a replace plan already.
   I'm pretty sure that actually the Republicans have a plan.  In fact they must have a dozen plans.  Problem is, they cannot get everyone (or even 51%) to agree on WHICH plan they are going to support.  Health care is a gravy train for patients, doctors, big pharma, insurance companies, hospitals, medical device makers, ambulance drivers, ambulance chasers, state governments.  Health care is 19% of the US GNP, that's a huge amount of money.  With that much gravy the spread around, no wonder everyone wants their fair share, and more if they can get it. 
  To pass anything at all, the Republicans need nearly every single Republican vote.  The Republican margin is thin, and in the Senate, a mere three defectors could sink anything.  I'm thinking that they won't keep their party in line, or even attract a few Democratic defectors, without president Trump getting behind ONE replace option and pushing it hard.  Which he hasn't done yet.

Saving money on health care

Bring back "hospitalization only" insurance policies.  Back before I became eligible for Medicare, there were two kinds of insurance policies.  The pricey, $12K a year, covers everything, no deductibles policy.  It would pay for doctor's office visits, yearly physicals, pills, everything.  Or, the $3K "hospitalization only" policy which only paid for things serious enough to put you in the hospital.  Everything else, doctor's office visits, pills, physicals, MRI's, you name it, you paid for it out of pocket.  On the other hand, the $9K saving on the policy would pay for a lot of incidentals.  If you were in decent health, and had some ready cash, the "hospitalization only" policy could save you a LOT of money. 
   Plus, since you were paying out of pocket, you tended to shop around, for good prices on pills, MRI's and the like.  I even talked my doctor into changing some of my prescriptions to the $4 a month Walmart pills.  You can cut costs noticeably when you have to pay them yourself.
    Then came Obamacare, which wiped out the "hospitalization only" policies.  Obamacare policies have to cover everything, chiropractic, maternity even for guys, eyeglasses, drug rehab, MRI's, CAT scans, head shrinking, you name it.  The medics loved that part.  So do the drug companies and the hospitals. 

US health care is too damn expensive

The United States pays put 19% of GNP providing health care to its citizens.  That is a staggering sum of money.  All the rest of the world gets by pays 8% of GNP, less than half.  And, for paying all that money, US health is just fair, we rank about15th or so.  Which means 14 or so countries manage to give their citizens better health care for half the money.  Note that not one of our intrepid newsies has ever run a story explaining how that happens.  Here is my list of what we ought to do to get the price down.
1.  Competition.  Allow insurance companies to do business in every state of the union.  Right now to sell insurance in a state, the company has to do 100 tons of state paper work, and bribe a lot of officials.  It's so bad that a lot of companies just don't bother.  That's why we only have two health insurance companies up here.  Pass a federal law that says any licensed insurance company has the right to sell policies in all 50 states whether the state insurance commissions like the idea or not.  The Commerce Clause of the Constitution oughta cover this.  This will bring some choice, and perhaps some better pricing to the private insurance market.  Insurance companies will hate this idea, but companies don't have the vote.
2.  Curb the lawyers.  The lawyers should not be allowed to advertise for plaintiffs on TV.  We need a law to prevent mal practice suits for proscribing, manufacturing, selling, anything, of any FDA approved drug or device.  Even if the FDA later dis approves said drug or device.  Everyone knows that the FDA has been super cautious about approving anything, ever since the thalidomide disaster back in the '60s.  After they do approve something, it's reasonable for any man to assume it's safe.  We should not allow suits against those men just because they did something reasonable.  The lawyers will hate this, but there ain't that many lawyers in the electorate.
3.  More competition.  Allow import of drugs from any reasonable first world country, say Canada, Britain, Germany, France.  People should be able buy anything in Canada that the Canadian authorities allow on their market.  US companies often sell drugs for much lower prices overseas, mostly because the overseas authorities insist on more reasonable pricing.  Which is why drugs are often much cheaper from Canada.  People ought to be able to take advantage of this.  The drug companies hate this idea, but again, companies don't vote.  The FDA hates this idea, but that's just a turf battle.
4.  Drop the "electronic medical records" scam.  Insisting that every provider keep your medical records on his computer, just means your medical records are visible to every hacker, every employer, and every enemy.
And it costs money and is driving the smaller providers out of the business.  Large providers like this "feature", but again, companies don't vote.  

Republicans need a platform to win this year

Despite all the pundits claiming this is a Republican year due to misteps by the Obama Adminstration, I am worried.  In 2012 Obama carried the women's vote by 10%.  That was enough to win the election coast to coast.  Women are half the voters.   Republicans do poorly with young voters, and that can be fatal.  As the seniors die off, the young voters take their places and if they are all democrats, we can kiss the GOP goodby.
   Let's talk about women voters first.  The Republicans need to get off the pro-life thing.  For every pro-life voter we gain, we lose a young woman who fears getting pregnant and not being able to stop it.  The party needs to stop backing all those little laws that chip away at abortion.  The party doesn't need to switch over to a pro-choice stance, it just needs to stop talking about it.  The ardent pro-life people will whine and cry, but in the end they will vote Republican.  And a lot of younger women will too.
   Health Care is a top issue with women, they are the caregivers who take the children to the pediatrician.  Unlike men, women are more likely to go to the doctor when something hurts.  Men are more apt to just tough it out, not wanting to loose pay or appear soft.  So healthcare counts, big time with women.  Obamacare is disliked by the majority of voters.  But the Republicans have not offered an Obamacare replacement, probably because they cannot agree on what it ought to be.  And Republican leadership has failed to get the party together on a plan, probably fearing that whatever they propose the media will savage them on it. 
   We ought to propose freedom for insurance companies.  Any insurance company licensed to do business by any state in the union, is free to sell insurance in all fifty states.  Right now, to sell insurance you have to get a license from the state you are selling in.  To jump thru fifty sets of paperwork hoops  to get licensed in fifty different states is beyond any company.  So a lot of states, like New Hampshire, only have ONE insurance company doing business in the state.   And, monopoly leads to price gouging.   Voters would love the idea.  Insurance companies hate it.  Insurance companies don't vote. 
   We ought to propose freedom to import drugs.  Any drug approved by the health authorities of decent first world countries (Canada, England, France, Germany, and some others) may be imported duty free and sold by drug stores.  This would drop the price of prescription drugs a lot.  Voters would love the idea.  Drug companies hate the idea.  Drug companies don't vote. 
   We need to clamp down on malpractice suits.  Right now every doctor has to pay $100,000 a year for malpractice insurance, unless he wants to be sued into poverty.  This is largely a matter of state law.  Up here in New Hampshire we did something about malpractice which cut the rate in half.  Other states could do likewise.  Voters are OK with this idea.  Lawyers hate it.  Although lawyers can vote, there aren't all that many of them. 
   We need to scrap the regulations that force gold plating of medical facilities.  For instance at  Dartmouth Hitchkok the main building is topped by a gigantic row of air conditioners.  Turns out, regulations require the hospital to hold temperature to 72 degrees plus or minus ONE degree. which is ridiculous, in addition to ridiculously expensive.   

Congressional Budget Office sticks its neck out

CBO just released a damning forecast on Obamacare.  They predict 800,000 lost jobs, 2.5 million workers put on part time, and a drag on the economy equivalent to a 1% tax hike.  Ouch. 
I wonder where CBO found enough backbone to speak up.  When they were forcing Obamacare down our throats, CBO released several studies claiming that it wouldn't be all that bad.  While anyone of common sense knew Obamacare would be expensive as a medium sized war.  At the time, excuses were made for CBO, claiming that they were required to forecast based upon the presumptions passed to them by Congress rather than sure knowledge of what will really happen.  For instance Congress could ask for a forecast with the assumption that the federal deficit would shrink.  Everyone knows that is unlikely to happen.  But if it did, wonderful things might happen, and CBO would dutifully forecast wonderful things.
   Yesterday's forecast was a bummer for Obama.  The TV news reported a lot of huffing and puffing from the White House. 
   Is this a sign that Obama is a lame duck?  And CBO figures he will be ineffectual if he retaliates against them? 

Security Fail

We now have two insecure databases, in which evrybody has an entry.  And both of them are wide open to hackers, crackers, and worms like Stuxnet.  All thanks to Obamacare for putting our lives on line for anyone to read. 
   Healthcare.gov is the first problem area.  Its security problems have been getting some attention from the newsies.  As well it should.  It's running on Windows,( everything runs on Windows) and anytime you connect Windows to the public internet, the knowledgeable hacker knows about 50 secret ways to take the Windows machine over completely, load and execute his own code, and force the victim Windows machine to do anything he likes.  Such as send all its data back over the internet to the hacker.  The only defense is to use the strongest possible encryption and even that isn't fool proof. 
   The second problem area is "digital medical records".  Obamacare is forcing all doctors to put all their patient's medical records on line.  Used to be, your medical records were kept in a file folder in a cabinet in the doctor's office.  Short of burglary, they were secure.  And it would take a very savvy burglar to find them, and a small truck to haul them all away. 
   Obamacare demands all the medical records be digitized and stored on line for everyone in the hospital to see.  This is supposed to be a cost cutting measure.  But, on line means hackers can get to it, and they don't need that small truck to haul them away. 
   Less than scrupulous employers will take a peek at the medical records of any prospective new hire.  Should that new hire have an preexisting condition, or treatment for drugs, alcohol, or mental health problems,  he can kiss that job goodbye.  In practice,  this guy will be unemployable.  Privacy means the ability to keep bad things in your past secret, to start over, and press on.  Now that we have Obamacare and on line medical records, forget about privacy.  

Just 'cause you got a cancelation notice

Doesn't mean you are uninsured.  You aren't uninsured until the cancellation notice takes effect.  So sayth Allan Colmes,  Fox News liberal gadfly.  So all of us who received cancellation notices effective in January, we aren't uninsured. 
   Great.  Thanks Allan for letting us know.

Death Spiral

For taxpayers that is. 
TV talking heads worry about Obama care going into a death spiral.  By which they mean only older and sicker patients sign up for Obamacare and the young and healthy won't.  Which means the insurance companies have to raise premiums to pay the bills, which means fewer and fewer healthy patients would sign up, 'cause it costs too much.  As the TV newsies tell it, the entire Obamacare plan would emit black smoke, burst into flames and make a big hole in the ground where it hits.
  Don't you wish. 
  In real life, the insurance companies will cry a lot, and head to the White House for a taxpayer funded bailout. 

What should Republicans do about O'care?

Well, the House has tried to repeal Obamacare, repeatedly.  That is kinda worthless.  The Senate won't go along, and even if they did, Obama would veto the measure.  Repeal just ain't gonna fly, at least not until after the 2014 elections, and probably not then either. 
   What about half measures?  Repeal the most obnoxious features, or roll it back a year?  What's in it for us?  Obamacare has pissed off the voters, but good.  It's eating into Obama's credibility, and clout.  Why do we want to stop that?  Let the ObamaDamage continue.  Sit back and watch the fun.  Pass the popcorn. Let the Democrats figure how to wiggle out from under.   We ought to refrain from saying "I told you so", because everyone understands that now, and repeating it just irritates voters, especially those who voted for Obama the second time.
   We should point fingers at all Democrats who voted for Obamacare and are running for re election.  As in "You did this to us". 

Sorry doesn't cut it

Obama actually managed to say he was sorry about canceling people's health care policies.  Too bad he didn't promise to fix anything while he was at it.  All talk, no action, that's our boy. 

Grilling Sibelius

Congressional hearing with Secretary of HHS, Kathleen Sibelius as witness.  Big house committee with lots of members, each one waiting for his moment of fame on TV.  Sibelius was evasive, and ducked and weaved.  She was clearly attempting to reveal as little as possible.  Democratic reps spend the morning thinking up softball questions to give her a break.  Republicans were unable to stay on topic long enough to really nail her down on anything.  The Democrats are totally into Obamacare and are defending it to the death.  A lot of Republicans opened their remarks by reading letters of insurance cancellation from their constituents.  There is a lot of that going around, Humana cancelled my Medicare Advantage last week. Sibelius did admit that a full up system security test had never been run.  That's scary.  Figure everything you put into Healthcare.gov is available to every hacker, including your social security number, your address, home phone, and medical history.   They got under Sibelius' skin when they asked why she, the head of Obamacare, was NOT on Obamacare herself.  Good question.  Apparently we did manage to force the Congress onto Obamacare, but the executive has skated, and stayed with their cushy gov'mint health insurance. 
   Anyhow everyone had a good time yelling at each other.  Little real information came out of it.  

Such a deal

The few people who have gotten thru to the Obamacare websites are reporting policies costing several hundred dollars a month, with deductibles of $4000 and up.   Such a deal.  If you are in good health, which most of us are, you won't rack up $4000 in doctor's bills inside a year.  So what are you buying insurance against?  You still have to pay out of pocket for everything under $4000. 
   Support you get unlucky and actually need an operation?  Those go for $20,000.  So you pay $4000 and the insurance pays off the rest.  Big deal.  How many of us have $4000 just lying around?  Damn few. 
   Most young single guys won't fall for deal like that. 

Will the young buy Obamacare insurance?

Probably not.  Most young people have jobs with big companies that already offer health insurance.  Obamacare is selling to the less fortunate who lack employer health insurance, and the self employed. Most of these people lack the money to buy any kind of health insurance.  They will sign up if it is free, but they can't afford  to pay for much.  They just don't have the money. 
   Plus, when you are young and single, and in good health, you don't really need insurance.  If you get sick, probably a single doctor visit and a prescription  will fix you up.  Maybe $400, every couple of years.  Why insure against that?
  Plus, if there is an accident, and the ambulance drops you off at the emergency room, they will bandage you, stop the bleeding, and set the fractures, whether you have insurance or not.  

Sauce for the Goose is sauce for the Gander

TV News has some victims of Obamacare wailing loudly about it.  First we have the Congress and Congressional staffers.  Since they invented Obamacare, and voted it in, it's only fair that they should enjoy the higher costs and reduced care they inflicted on the rest of the country.  Then we have the IRS, so impartial, so fair, and getting a big boost in budget, authority and manpower to ram Obamacare down the throats of the rest of us.  It's only fair that they should be sticking it to themselves as well.

Sibelius Shakedown

Obama's secretary of HHS, Kathleen Sibelius, has been calling CEO's of industries her department regulates asking for money, "voluntary donations", to fund Obamacare.  Congress has refused the funding and so to bypass Congress, HHS is atempting to raise the money "privately".
    Imagine your phone rings.  It's Ms.Kathleen Sibelius, or perhaps its Secretary of HHS Kathleen Sibelius.  You take the call.  She asks you for money.  What do you say?  Knowing that bureaucrats under her command can make your life and your company's life, a living hell. Real voluntary that donation is.
   Someone on NHPR said this was OK as long as Ms Sibelius  didn't use here title over the phone.  As if anyone in the health business wouldn't know who she was. 
   It may be legal, but it sure is tacky.  Most people call it blackmail. 

Who cares if it's a tax?

It's money out of my pocket, I don't care if you call it a tax or a penalty, it's still money taken away from me.  I don't like that no matter what you call it.
  Newsies and other twitterati get all excited about "precedent", claiming that a "precedent" might win a future court case.  Yeah right, but we lost this one now and we lost it big.  No amount of "precedent" can make up for that.  Plus the courts rule any old way they want to.  They don't pay attention to "precedent" in real life, although they claim they do.
  So let's drop the "is it a tax or is it a penalty" talk.  Every time I hear the TV start in on it again, I reach for the remote control. 

News Domination

That Roberts court sure knows how to take over the news.  It's been nothing but talk about the Obamacare decision since Thursday.  Needless to say, I was disappointed that we are still stuck with Obamacare with just a slight watering down.  I had been hoping the Supremes would save us from our own folly.  No such luck.
  We will have to do it the old fashioned way, at the ballot box in November.  If that doesn't work, the US of A goes down the same drain Greece is going down today.  So far Obama care has jacked up everyone's insurance costs and  has kept un employment high thru classic FUD (fear uncertainty and doubt) tactics.
   All I can figure is Roberts feared the uproar that Obamacare repeal would cause, and rather than be subjected to the storm of criticism, he found a face saving out that leaves Obamacare still at large in the land.  Good courageous lawyering at work.