Obama Care is Taking On Swamp Water

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Trump has just put a hole into Obama's signature legislation, The Affordable Care Act commonly known as Obama Care. It is ironic that the home of the Obama library in Jackson Park is in sight of U 505 the German submarine at the Museum of Science and Industry at the Northern end of Jackson Park. Such a symbolic image for the torpedoing of Obama Care. The swamp of insurance company lobbyist has poured millions of gallons of Chum (dollars) to feed the Congressional GOP sharks led by Representatives John Boehner and now Paul Ryan and Senator Mitch McConnell will see it all wasted. Mitch isn't doing a good job in finding fish to fill the holes of the insurance company commercial fishing boats. He lost a huge amount of chum in the special election Alabama GOP Senate primary. And this week the move of twitter, liberal company, to first ban has been forced to show an add for Tennessee GOP senate candidate Marsha Blackburn to replace Corker. She point blank is anti abortion. The Twitter boost to her campaign will likely put her in the Senate.


The executive order Trump signed in the Roosevelt Room Oct. 12, 2017 at 11:15AM in effect breaks the monopoly of states to regulate health care and gives all self insured citizens, 28 million an option to purchase group insurance called "Association Health Plans." The Senate rules Mitch McConnell and Chuck Schumer used to prevent an effective repeal of Obama Care will not prevent them from attacking the executive action.


The present Obama Care requirement for pre-existing condition will remain but with the plans extending across state lines and even for the whole country, they will be exempt from some of the Obamacare and State regulations. With such purchasing power the insurance companies will have to compete for their business and one would expect prices to drop.


Now low paid individual can create an association and demand a policy the fits their income and good health care. This will put pressure on the insurance industry to lower the cost of all policies.


The bureaucrats in Washington will be tasked with writing the regulations for this executive action. This is the fly in the soap. They will drag their feet and sabotash it where ever they can. If they have their way we will have to live with Obama Care until at least November of 2018. And they will put loop holes to maintain insurance company profits.   The insurance companies will also drag their feet. Why would they want to end the gravy train? So do not expect to see any plans until after the election, thus in 2019.


But this will happen if we, all 65% of the population that wanted Obama Care repealed and want lower cost and better health care does nothing. So what can we do?


Create those Associations to purchase health care. Then use the association as a lobbyist to pressure the House and Senate to pressure the regulators. Demand that the people see drafts of any regulation very early. And demand they move quickly. Give them the date not let them give us a date. The insurance companies will see the pressure placed on the regulators that they normally control and respond to our advantage.  We have to hold the regulators feet to the fire and tell the insurance companies they are next in line.


Why should we do this is simple. We will get better health care for less money out of our pockets.


Even if your on welfare you can create an association.  You can use the bargaining of the other associations to demand equal treatment.


Finally you will have access to doctors presently blocked by the low payment amounts of the system. And it may happen that the government will actually spend less because the market is setting the cost not a committee of doctors serving their own association members.  It is not accident that health cost increase faster then inflation.  The government is the biggest purchaser of health care. 


VA and Medicare can also organize into association to bargain for themselves.  These government monopolies are full of graft and corruption.  We can do a better job because we can switch to another association or create a new association if one become inefficient and does not perform.  


We are not alone, that is the key for any self insured or person receiving government monopoly controlled insurance.   


Dino Manalis Added Oct 12, 2017 - 5:18pm
Trump's executive order is a first step, I hope it's included in some other legislation, then we need to import foreign prescription drugs and cap medical malpractice compensation.  We can improve ObamaCare with market reforms!
Stone-Eater Added Oct 12, 2017 - 5:25pm
Do it, Thomas. Get some people to support if you think your idea is OK. Finally you're living in the land of freedom where everyone can make it !
Irony ? You decide.
Thomas Sutrina Added Oct 12, 2017 - 5:47pm
The big players in this are the small businesses employees without health insurance waitresses, waiters, hair dressers, barbers, clerks, salespeople, etc..  Church groups have already taken advantage of I believe this hole by paying bills of members out of the monthly fee that is the sum total divided by the members.   
Another key is numbers.  The church groups members do not present a large enough group of purchasers to change prices set by the insurance government regulated monopoly  which was a state regulated monopoly before Obama Care.   To break the monopoly you need a guess of  ~ 7% of the market and the support of small company customers demanding also better value.  And you need to end state monopolies.  
Leroy Added Oct 12, 2017 - 6:02pm
The USS Obama is taking on water.  Let's see if the hole will be plugged by Congress before it sinks.  I imagine the US SC will plug the hole for the gutless Congress.
Utpal Patel Added Oct 13, 2017 - 7:27am
You misunderstand the importance of the executive order. It doesn’t under-cut insurance companies in the slightest. The insurance companies will be selling plans to these associations. The associations can simply buy policies with pre-tax dollars. It works like this, take pre-tax earnings and donate it to your church. Then have your church funnel the money to the insurance company on your behalf. Prior to the executive order, individuals had to buy insurance with post-tax dollars. Of course it also helps in terms of affordability to avoid costly state and federal coverage mandates.
Thomas Sutrina Added Oct 13, 2017 - 8:06am
Utpal P., associations are like unions or a business that can bargian for lower prices.  The more members the better position you are in.   Add more competitors by going to other states give you the purchaser a better position.   That is called a free market.  Historically you get lower prices and/or better products.
Dave Volek Added Oct 13, 2017 - 12:51pm
Unfortunately I can't comment directly on this topic because I just don't have the background knowledge on American health care (except the insurance companies are running the show).
Your idea sounds like a great approach. Some great out-of-the-box thinking indeed.
Thomas Sutrina Added Oct 13, 2017 - 2:22pm
The Democrats in their wisdom put in the ability for the executive branch to be actively fixing the health care bill since they knew it would have problems.  But they did not thing they would loose control of the house or the senate.  And they planed for 6 years to put all the features of Obama Care in place before the bill came due.   
Trump is using those features to adjust Obama Care to open it up to cross state insurance. Hillary would have eliminating the state monopolies that have existed for decades.   Trump is eliminating state and federal monopolies. 
Today or yesterday he cut off the piggy bank to insurance companies.   The GOP house would not approve of the spending on features of Obama Care like bail out of insurance companies, but Obama just did it.  The courts would hold off the GOP until after Hillary was president.  
Trump is a smart businessman, and he is laying the responsibility taken by the executive branch from Congress back in their laps.  They are getting egg on their face almost daily.
Obama Care will be going broke at a faster pace after the stopping of payments.  The insurance companies are on the hot seat.  Not provide affordable policies and the citizens will be mad.  Get congress to approve money to pay them will be obvious to the voters and make them mad.  They loose either way. 
Trump also dumped immigration and treaty executive actions of Obama also back in Congresses lap.  McConnell is in the hot seat because the senate is the choke point since he has no maneuvering room.  The few conservatives in the Senate got elected despite McConnell running people against them.  McConnell is beholden to K street lobbyist.  To pass bills he has to throw them under the bus or get democratic votes which will through the both Democrat and Republican senators up for re-elections under the bus.  
Donna Added Oct 13, 2017 - 4:05pm
A few questions
1- When will all of this happen? Exchange starts now, if no one is going to cover the old insurance, how will the millions on it survive until this passes? In my state most have already pulled out, and i have been hearing from friends, that they are being offered only 1 plan.
2- with the way he is describing doing this, does this mean the small barber shop my gent owns, can combine with say 5-10 in the Southern states and make it cheaper for all? I mean no union for them anymore, but if they do as you say and become an association, that would work? 
3- How do we accomplish this, i mean reach out to other shop owners, see if anyone is interested, then approach who? I need guidance if we are going to attempt this type of thing from state to state.
4- How do you see this working long term?
Mike Haluska Added Oct 13, 2017 - 4:07pm
Thomas - spot on analysis!  What the Republicans need to remember is that for every person benefitting from a subsidy, 3 are paying for it!  They shouldn't worry about losing the votes of subsidy recipients because:
1) 98% vote Democratic anyway
2) the people who got President Trump elected are the ones paying the subsidies
Thomas Sutrina Added Oct 13, 2017 - 4:55pm
Donna, the best guess is 2019.  That is if we do not put a fire under our representatives.  A big hot fire.  And that may happen because without subsidies more of fly over counties will have not insurance providers.  and everyone's prices are going up fast.  I believe the 2018 prices are not set in stone.  This will cause them to rise.
The choice for areas that have already lost coverage is christian co-operative policies.  The subscribers each month get a piece of the bill for the group.  Your paying for a person's costs and you may even get the person's name.    This is how they get around the insurance rules. 
Insurance companies do the same thing.  About 70 to 90% fee they charge go out the same month to pay person's costs.  They have a piggy bank for fluctuations.  The big groups have so many subscribers that the fluctuations each month are very small.  They can not have the piggy bank.   But then the management fee is low so you get the saving instead of the stock holders of the insurance company.    Like anything else their are scam providers.  And they are not as highly regulated so be careful.  Many have been around for years and word of mouth should help in the review.  
Form an association of barber shops or even every small employer in a town.   You set the definition of the association.  Unions of building constructions that work at dozens of different sites for dozens of different general contractors have formed associations, the union, and purchase insurance for decades.  This is not new.  What is new is that the door is open to more then just unions.
Start talking to others that have the same problem with insurance.  I do think that you have to have some reason to join together.  A mixture of people that have nothing in common will have needs that are not in common.   The goal is to have people with similar needs so they ask for a common set of insurance requirements.   unions is the best example of how well it works.  
Benjamin Goldstein Added Oct 14, 2017 - 6:40am
So the executive order creates a loop hole in the state regulation monopolies. People can sideline the state by forming associations across the borders and thus a free market is finally able to foster.
I somehow don't see the swamp water bit.
Thomas Sutrina Added Oct 14, 2017 - 7:31am
Benjamin G. the state and federal monopolies is the swamp water.  It is a swamp because people took the alternative, pay the fine instead of purchase the insurance.  How clear a message does anyone need.  I am excluding John G.  because he need a sludge hammer to get his attention.  But most people got it.  
John G. a lot more people that had insurance lost insurance because the company in more and more counties stop offering a policy. The choice left was none.  The price was beyond their means so they choose food, roof, clothing, and transportation over health care.  They lost their doctor and couldn't keep their health insurance.  Three promises Obama made to sell Obama Care John G. that were pure lies.
Those people that were poor did not get Obama Care John G.  They were enrolled in Medicaid that is not part of Obama's health care plan.  Obama bribed the states to offer it to people with less need.  He or congress or the states could have done this without wrecking the health care for the purchasing public.
Benjamin Goldstein Added Oct 14, 2017 - 7:40am
Thomas: I need some extra hints because I don't know the details of your system. I knew that the states legislate most of the health care stuff. So this portion of swamp water was already in. I assume you mean that the federal government is now taking more control of it, making it even more swampy. 
Melina Ahl Added Oct 14, 2017 - 9:24am
Sex Offender has not+ committed this crime against you people (USA citizens) yet; he just said he plans to do so. He wants more USA citizens dead: why do you put up with that? The ACA by the way is not "Obama's:" it was created / written by the hyper-conservative American Heritage Foundation.
Before the ACA, about 46,000 USA citizens died every year due to the lack of medical care; the ACA has lowered that number to about 40,000 a year. Sex Offender wants to kill more citizens. Doesn't this bother anyone in the USA?
Leroy Added Oct 14, 2017 - 10:22am
What did Weinstein have to do with the ACA?
Dr. Rupert Green Added Oct 14, 2017 - 11:34am
@Thomas. Your article appears well reasoned. But given your anti-Obama stance, I will have to expose your work to rigorous scrutiny. Autumn got me out of my political battle to comment on your work. Cant do much thinking now, so a fitting comment is not forthcoming.
I will say this: As President Obama was the genesis of President Trump, President TRUMP IS LAYING THE FRAMEWORK FOR THE FIRST WOMAN PRESIDENT. Thus, those taken aback by his actions can harken that he will have to undertake more unpopular actions to have Americans seek relief in a woman president.
Thomas Sutrina Added Oct 14, 2017 - 12:14pm
Dr. Green, if Obama kept his 2008 campaign promises about health care I would have not had a anti-Obama stance.  I disagree with the Nuclear deal because he skirted the treaty process in the Constitution.   He was not the first president to not enforce laws because of his interpretation.   I did not see him as a president working on uniting different races.  But that to is not uncommon.
Have you noticed I have an anti-stance to the leadership of the GOP for the same reason.   7 years of promising to repeal Obama Care, 7 years of kabuki theater in the House and a few in the Senate.   Years of not using the purse strings to rain in spending that they said they would do.   They are at par with Obama and the Democrats in Congress.  
Trump until this week did not get much praise from me also.  He has not kept many of his promises.  Trying to find a middle ground with the GOP leadership and sparing with Democrats and the Media has been all that he has done for 8 months.  Two successes, Supreme Court judge and NFL take a knee.   
I am not against what the NFL are protesting I am against those players not telling us before and after every game the reason and listening to the fans and adjusting accordingly.  You see the fans came to their own opinion. And that is lack of respect of those that spilled blood and risked their lives on a battle field with that flag waving on that field.  Vietnam included a lot of black solders.   A bullet doesn't discriminate.  WWI and WWII  Wilson and FDR mandated discrimination in the military and government offices.  LBJ for Vietnam did not.  I think the poor and middle class did more then their share but in the history of war that is not unheard of.
Bill H. Added Oct 14, 2017 - 5:25pm
During private meetings with healthcare insurance executives, it became obvious who was really going to craft Trumpcare. The priorities were, and still are, increased profits for the industry and the ability (no matter how they try to hide it) to eliminate the mandate to cover pre-existing conditions.
No matter what the outcome of this latest "Executive Order" is, the intent was to accomplish anything at all that will get those profits going up in the long run. If you believe otherwise, then I'll sell you a bridge.
Saint George Added Oct 14, 2017 - 10:15pm
Obamacare never had anything but swamp water. It was meant to fail from the get-go.
I understand President T is going to issue an executive order de-clawing it. Thanks God for that.
Mike Haluska Added Oct 19, 2017 - 12:39pm
Bill H - your accusation:
"During private meetings with healthcare insurance executives, it became obvious who was really going to craft Trumpcare."
is 100% spot on!  Where the hell were you 8 years ago when the exact same thing occurred with Obamacare??? 
- Remember it being drafted in secret by people whose identities were kept secret? 
- Remember the 5,000 page document being given to Congress and the American people with 2 days to read and comprehend it? 
- Remember "Nitwit Nancy" Pelosi saying "we have to vote for it so we can see what's inside it"? 
- Remember it being voted on Saturday, Christmas Eve and needing the vote of the VP to be passed with NO REPUBLICAN SUPPORT OR INPUT?
- Remember EVERY SINGLE PROMISE made by Obama (you can keep your doctor, you can keep your health insurer, your premiums will go down, you will have choices, etc.) that was a flat out LIE?
You have a selective, short memory my friend.  Here's my prediction - whatever the Trump Administration does you'll bitch about despite the fact that Obama did the exact same thing!  Just like when Obama put 7 nations on terror watch list/restricted travel and then 2 years later  President Trump issues travel restrictions on the exact same nations and it magically becomes a "MUSLIM TRAVEL BAN"!!!
Thomas Sutrina Added Oct 19, 2017 - 12:55pm
Bill, John, and Mike, that was tried by the passed Ryan Care, "repeal in name only," but failed when McConnell Care was presented.  And any other Senator could not get a "repeal in name only" or the 2016 vetoed bill passed. 
The Democrats lost all the special elections  (one remaining and predictions failure), and Judge Moore blew out the McConnell and Trump candidate despite spending about ten times.   That win also I hope just brought home that GOP leadership did not cause the loss of 1000 legislative seats by Democrats, governorships, and the president.  The people that wanted the lying to stop and wanted their money left in their pockets won.   
Mike Haluska Added Oct 19, 2017 - 3:03pm
Thomas -
Great summation of what is actually going on.  The frustration of working people in the "flyover states" finally reached critical mass and President Trump was the only Republican candidate to recognize it.
Saint George Added Oct 19, 2017 - 9:42pm
LOLzZzZzZ! "RawStory"!
Raw Story demonstrates left wing bias in reporting and story selection. Raw Story has a Half-True claim with Politifact and an Unproven claim with Snopes. (5/15/2016)
The Raw Story (styled as RawStory and run by Raw Story Media Inc.) is a self-proclaimed progressive Internet news site, featuring redigested clickbait. Never take a RawStory headline at face value: it is rarely actual fake news, but you will need to de-spin its content. RawStory ranks in the top 4000 websites worldwide, granting it about 25 million monthly visitors.
Thomas Sutrina Added Oct 20, 2017 - 8:37am
John G., Obama VA a single payer plan does the same thing to veterans,  Medicare and Medicaid do not pay for all procedures which  is a death board is those single payer plans.  So I am not surprised that insurance companies consider procedures too expensive and not proven.  They have death boards to, "target="_blank">Insurance company sends letter to 9-month-old boy explaining he’s too expensive to keep alive."
I can switch to different insurance company. I can not switch to a different single player plan if I do not like their death board list of things not paid for.  And if enough people agree with me an insurance company will take things off the list.  How do I get a single payer plan to do that when I have no leverage. 
We already know that they do not care about the money coming out of my pocket.  Their pricing boards always favor the one getting paid.  That is true with all monopolies government or private.
John G., only when their is an incentive of lowering cost will costs actually decrease and the procedure become less expensive.  I am not saying that single payer plans always make bad decisions since the creation of dialysis centers is the result of one of these three, Social Security, Medicare, or Medicaid.  But John private enterprise with government as the umpire statistically has done better in history.
Mike Haluska Added Oct 20, 2017 - 3:26pm
Melina - you're back!  Your claim:
"Before the ACA, about 46,000 USA citizens died every year due to the lack of medical care; the ACA has lowered that number to about 40,000 a year."
is a great example of misinformation based on vague unquantifiable "facts".  Did the people who were killed on highways in auto accidents "die due to lack of medical care" because they bled to death before help go there or because their health insurance was expired?  Did the alcoholic/drug addict who chooses to abuse himself and dies due to overdose or exposure "die due to lack of health care"?  Just where does "46,000" come from?
What about the millions of families that LOST their health insurance because of Obamacare?  All I ever hear about is the people who didn't have health insurance and now do.  You live in an artificial environment where your needs are magically taken care of by your parents.  Please check in when you are actually on your own and have had a dose of reality. 
Thomas Sutrina Added Oct 21, 2017 - 7:45am
Talk about deaths with only the total number is like squeezing a slimy pumpkin seed.    Hard to get a grip on the reality.  On TV I just heard that the number of people without insurance doubled from 2009, before Obamacare.  Now on the list of objectives in the 2008 debate on health care Obama put covering everyone as a main objective.   So why do we have more?   The higher by far up front cost, deductible before receiving any money, value from Obamacare is beyond the means of many people and then the cost of Obamacare is also very high for the actual care then receives.  Most of the people that choose not to purchase Obamacare spend far less then the required deductible.   The fine was a better deal.   
The reason cost are out of control, death spiral, and insurance companies are dropping out of markets is that these people that said the fine was a better deal were as Prof. Gurber told us the health people that would pay for the sick people.  The people that receive welfare do not pay so they signed up for Obamacare or Medicaid as directed by the people Obama hired to help them choose a plan.  
Mike Haluska Added Oct 23, 2017 - 12:02pm
John G - your claim:
"Those tens of thousands of people dying each year for lack of medical care have been rejected by the death panel of big finance's profitability."
is easily disproved.  Name ONE PERSON who died strictly due to lack of ability to pay for health care in the US.  If there are really "tens of thousands" of people like you claim, you should have no problem finding one example.
There are two distinctly separate issues that you and lots of others on the Left routinely confuse/consolidate.  They are:
1) access to healthcare
2) paying for healthcare
Now it's true that if you become seriously ill and don't have adequate health insurance you may lose your savings, home, assets, etc.  Personally, if I believed I still had a few good years ahead of me and I could whip my illness but it would cost me everything financially, I would probably do it.  If I was very elderly and every day I woke up was a bonus, I would  opt not to bankrupt my family and succumb to fate.  But that would be MY CHOICE - not an Obamacare "Death Panel's" choice!!!
We all have to be mature, responsible adults and accept we are NOT going to live forever.  Those of us with children look at life and death differently than those without them.  In all cases, we should all be free to choose our own fate - NOT some "Death Panel"!!!   
Thomas Sutrina Added Oct 23, 2017 - 1:30pm
Thank you Mike H.  You took the slime off the pumpkin seed.  Short, to the point, and accurate.  My mother-in-law was in the latter class and make the choice to just get pain management care.  The doctors were not actually accomplishing anything so she decided that they couldn't make her better.  The body was wearing out.  The goal switched to making life as good as possible.  It also takes time to really settle oneself to death.  She had that time and as I have found out from many other people a person does have some control of death.  They often wait for a person to say their goodbyes and they often do it with few or no family members around, the crowd left. 
My father died before the party for his 100th birthday so we wouldn't have to return.    Mother wanted to die at the home they lived in but that was not possible so he waited to be out of the hospital and died in the assisted care facility that my father spent 12 to 16 hrs with her every day.
Mike Haluska Added Oct 23, 2017 - 3:07pm
Thomas -
Thanks for your compassionate post.  For the life of me I can't understand why anyone would want such a serious part of their existence callously mismanaged by some unknown bureaucrat.  When I had my Classic Car Restoration Shop I met quite a few wealthy individuals.  Some of them were in poor health and would have gladly traded everything they own just to be healthy again.
opher is in love with the UK's Single Payer System.  I pointed out that if he was a certain percentage "overweight" that he would be refused joint replacement surgery.  I hadn't heard a clever response to that yet.
Thomas Sutrina Added Oct 23, 2017 - 4:34pm
You will never get a good response.   I do not have the article but read it.  The bureaucrats in England can not escape the system either.  On hospital supervisor needed surgery that was put of for months because each time she was scheduled an emergency person took her operating room and personnel.   The doctors performing the operation as with your person said their is still time, she can wait this emergency is critical now.  We do not get paid for overtime so we will let her and her family stay at her bed side for a little longer.  Well she died waiting.  They didn't guess well it seems.  She never became that critical patient.  She was just the frog in the pot of water being heated.
Bill H. Added Oct 28, 2017 - 3:46pm
The issues with "Obamacare" should have been reviewed and corrected with input from both parties. Yes, it has it's faults. What Trump is proposing to replace it with is a disaster for everyone except the rich.
The ones who would suffer the most would be Trump's voter base, but they appear to have no clue.
Thomas Sutrina Added Oct 29, 2017 - 6:17pm
Bill H., the review is in.   The facts speak for themselve we do not need Congress to discuss the facts that clearly say Obamacare is in a death spiral.
** None of the major promises have come true. 
** More people are without insurance then before Obamacare. 
** More people have obtain health services by being signed up for Medicaid. 
** Insurance rates have been increasing every year
** More and more rural counties either no company providing Obamacare insurance policies  or one for the individual market. 
Bill do you have an Obamacare individual policy.  You can tell us Bill H.  Be honest.  Medicare is not an individual policy Bill so do not spin us if your are retired 65 or older.
John G.  Instantly die in a car accident or drop dead and all the insurance or no insurance make any difference.  You and I can not separate them from those that get some to long term care or just emergency room care and have no insurance.   
You provide us John with the data from say the federal government.   

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