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Health Care Policy Forum, With Kindly And Mavericky Grandpa McCain

[ 75 ] June 16, 2017 |

Beloved media icon and losing presidential candidate but not of the gender that gets instructed never to be seen in public again John McCain has some very detailed thoughts about health care policy he would lake to share as he prepares to vote in favor of a bill to take away health insurance from 23 million people to pay for a massive upper-class tax cut:

Tara Golshan, Vox

Generally, what are the big problems this bill is trying to solve?
John McCain

Almost all of them. They’re trying to get to 51 votes.
Tara Golshan

Policy-wise. What are the problems [in the American health care system] this is trying to solve — and is the bill doing that right now?
John McCain

Well, it’s whether you have full repeal, whether you have partial repeal, whether you have the basis of it. It’s spread all over.
Tara Golshan

But based on the specifics of the bill you have heard so far, is it solving the problems [in the health care system]?
John McCain

What I hear is that we have not reached consensus. That’s what everybody knows.
Tara Golshan

Right, but outside of getting the votes. From what you hear of the actual legislation being written, is it solving the problems you see —
John McCain

It’s not being written. Because there’s no consensus.
Tara Golshan

But generally speaking, what are the big problems it is trying to solve?
John McCain

You name it. Everything from the repeal caucus, which as you know, they have made their views very clear — Rand Paul, etc. And then there are the others on the other side of the spectrum that just want to make minor changes to the present system. There’s not consensus.

“The problem Obamacare repeal is trying to solve is repealing the Obamacare.” Very compelling. Surely Chuck Grassley has a better answer?

Jeff Stein, Vox

I want to ask a very broad question: What do you think this health care bill will accomplish that will improve America? What’s the positive case for this bill?
Chuck Grassley

Well, I can tell you what it’s going to do for Iowa. We are one of those states that in a couple of weeks if [the insurer] Medica pulls out, we’ll have 94 of our 95 counties won’t have any insurance ,even for people who have the subsidies. That’s what we have to concentrate on now.
Jeff Stein

How do you think the bill will fix that problem?
Chuck Grassley

Well, by bringing certainty to the insurance market. They don’t have that certainty now.
Jeff Stein

By bringing certainty to the insurance market. What certainty?
Chuck Grassley

What?
Jeff Stein

What do you mean by certainty?
Chuck Grassley

Well, they can’t even file. They have to check the rates real high if they don’t know what the government policy is. And so the certainty is that passing a bill gives the health insurance companies certainty.
Jeff Stein

Wouldn’t not passing a bill also do that?
Chuck Grassley

No, it … well, yeah — it gives them certainty that you’ll have a lot higher rates than if you pass the bill.
Jeff Stein

So you’re saying [the bill] will lower the rates?
Chuck Grassley

Um, if you’re talking about lowering the rates from now down, no. The rates could be way up here. [Points to sky] And if they — if we get a bill passed, it maybe wouldn’t go up or would go up a heck of a lot less than they would without a bill.
Jeff Stein

By “rates,” are you talking about premiums?
Chuck Grassley

Yeah, premiums. … I’m sorry I have to go.

It’s pretty much all like this. It’s good that the Party of Ideas is finally in charge!

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  • From the very beginning, Republicans knew they were supposed to hate the ACA. They didn’t know why they were supposed to hate it, they just knew that it was their duty.

    I think the simplest thing to do would be to repeal the death panels and the government bureaucrat who sits with you in the doctor’s office, and leave the rest of it intact.

    • epidemiologist

      Sometimes I really wonder why they don’t. They could change nothing but the name, claim to have “repealed and replaced” ACA, stop trying to sabotage the health care markets, and claim to own our improved health care system to their uninformed partisans and others from now on. Instead they are making a spectacle of trying and failing to hide a bill even their pig-ignorant constituents can tell they don’t like the sound of.

      Then I remember the greed and the malice.

      • Rob in CT

        Right. The extra 3.8% capital gains tax and the .9% extra Medicaid tax for high-earners. THESE AFFRONTS TO MORALITY CANNOT STAND!

      • Steve LaBonne

        And specifically, the $600 billion tax cut for the rich that dare not speak its name.

      • JKTH

        Also politically motivated people wouldn’t accept that and would primary the shit out of them.

        • ExpatJK

          ^^^I think this is the big driver.

      • CP

        They’ve spent their entire lives doing everything they could to fuck the poor and telling themselves that was the gateway to a better world. How can they stop now? It’s scorpion-and-frog at this point.

        • epidemiologist

          Oh of course, but to their barely-sentient trashpile supporters, who can barely string together a credible sentence about what they think health care policy should do or be, I’m pretty sure they could just lie and claim to be really sticking it to poor people and get the same approval.

          Many of them, even ones I know can read and do a passable impression of a smart person at work, still think lots of people lost meaningful health care coverage because of Obamacare and some even think whatever the hell is happening now is “a start”. These people don’t know anything a conservative authority figure didn’t tell them.

  • BiloSagdiyev

    “That’s right. I did the iggy.”
    https://www.youtube.com/watch?v=qxW8Keb69W8

  • BiloSagdiyev

    “Oh! The uncertainty!” in this context, meaning, “Rent-seekers want guarantees on their rent collection. Or increases. Or both. Make that everything.”

  • so-in-so

    Good to know that while they dumbed-down their electorate, they also stupefied themselves. Equality!

    In a generation or so they will need service animals or assistants to find their seats or the exit.

    • Hogan
    • efgoldman

      while they dumbed-down their electorate, they also stupefied themselves.

      While I bow to no-one in my cynicism and my expectations of how low the RWNJs can go (limitless in both cases), I’m not sure that interviews with two doddering, drooling, incoherent, stuttering old men really proves anything.

  • Derelict

    Always remember that the Republican view on healthcare is that YOU have too much of it. YOU are the problem because you go to the doctor when you’re sick.

    This why you hear so much bullshit about “patient-centered care” and “letting the market work” in healthcare. Costs should be high enough to discourage people from getting healthcare unless they REALLY needs it. And even then, they should be forced to make choices between, say, chemotherapy and continuing to live indoors so to make sure they’re not signing up for painful procedures and intrusive surgery simply to take advantage of the bargain rates insurance provides.

    • Actually, I think you are over thinking it. The Republican view on health care is that it’s a commodity, and if you can’t afford it, then you can do without. Just like an extra cup of coffee, see?

      • ExpatJK

        Yup, this. Wasn’t there a GOPer comparing it to shoes some time ago? “Who needs that heart transplant, I mean extra pair of heels?”

        • Procopius

          There was some snollygoster who compared health insurance premiums to a new iPhone. He is apparently so rich that he doesn’t know how much he’s paying for his health insurance and probably doesn’t know how much an iPhone costs, but he did know it costs several hundred dollars. I don’t think there’s anyplace in the states where you can pay less than a couple thousand a year for health insurance, but never mind.

      • Derelict

        I’d agree, but I’ve had several Republicans (including a former Republican candidate for governor here in Vermont) tell me this in exactly these terms. They really don’t understand how healthcare works, they don’t see it as being any different than selecting a new refridge or hiring someone to paint your house. The fact that you’re having a heart attack and can’t really shop for a better deal is completely meaningless to them.

        This is why you hear the “serious” argument that nobody goes without healthcare because emergency rooms exist.

        • CP

          Although you also get the argument of “well, you should have planned ahead of time!” that tickles their moralistic side.

    • CP

      Costs should be high enough to discourage people from getting healthcare unless they REALLY needs it.

      Which, as it happens, is already how it works a lot of the time. Even with health insurance, costs are so ridiculously opaque and the billing is so systematically done wrong that I minimize my exposure to the system as much as possible.

      ETA: this isn’t specific to a particular insurance company. The entire system is like this.

  • Incontinentia Buttocks

    Funny how none of them mention the $600 billion tax cut.

    • Denverite

      This. So much this.

      Vox asked one of the senators, but really, they should have asked every single one of them:

      “The House bill — and reportedly, the Senate draft — cuts $800 billion from Medicaid and channels that money to a tax cut for people making over $250k. How, specifically, will that decrease premiums or increase access to care?”

    • But, see, that’s because that’s not the purpose of the bill. If it was, it would be the Killing Poor People to Lower Taxes on the Rich bill. But its not. So the $600 billion tax cut is just a side benefit. Not really the purpose of the bill, otherwise it would say so in the name.

  • Hogan

    Um, if you’re talking about lowering the rates from now down, no. The rates could be way up here. [Points to sky] And if they — if we get a bill passed, it maybe wouldn’t go up or would go up a heck of a lot less than they would without a bill.

    Who can really know anything for sure in this crazy modern world? Is it time for my nap yet?

    • Mike G

      He’s just an Unfrozen Cave Man Senator. Our modern world frightens and confuses him.

      • BiloSagdiyev

        +1 Keyrock

  • Chuck Grassley

    Well, I can tell you what it’s going to do for Iowa. We are one of those states that in a couple of weeks if [the insurer] Medica pulls out, we’ll have 94 of our 95 counties won’t have any insurance ,even for people who have the subsidies. That’s what we have to concentrate on now.

    You see, what we have to concentrate on is that one county out of 95 will still have insurance, and the only way to mange that uncertainty is to get rid of insurance in that one county so that all counties will certainly have no insurance. Get it?

    • Hayden Arse

      Once we take healthcare from those Johnson County Liburls, we will have MAGA!

  • Jon_H11

    How do they think the massive increase for premiums for the elderly is going to rebound electorally?

    They’re going to jack rates up on high-propensity voters (up to 3x from what I’ve seen, thousands of dollars! and that’s in the first order effect, not after it screws up the entire system) to maybe*(not likely, as at least Portman admitted) lower rates a bit for millennials– who definitely aren’t going to vote Republican because their yearly premium is a few cellphone bills lower and the benefits are shit and deductible higher.

    I think they’ve just entered this world where actual events don’t matter– it’s all winning-the-day on cable news.

    • Denverite

      How do they think the massive increase for premiums for the elderly is going to rebound electorally?

      Near elderly. The elderly are on Medicare. It’s the people in the 55-65 range who are well and truly screwed.

      But do keep in mind that many — probably most — of those people get insurance through their employers or (in the case of early retirees) their former employers.

      • Thom

        “It’s the people in the 55-65 range who are well and truly screwed.”

        That is part of what seems odd about the AHCA. Doesn’t that age group tilt Republican?

        • Denverite

          That why the other bit is so important. If you get insurance through your employer or former employer, you’re pretty much fine. So it’s only the 55-65 year olds who have to get insurance on the private market who are affected. I have a real question as to whether their votes skew one way or the other.

          • Steve LaBonne

            Depending on how the final bill is actually written, people with employer policies could see a return to lifetime caps and even exclusion for pre-existing conditions. So they may not be so fine.

            • Denverite

              Depending on how the final bill is actually written, people with employer policies could see a return to lifetime caps and even exclusion for pre-existing conditions. So they may not be so fine.

              Yes on the first, but that’s a concern to relatively few people (although to those who it is a concern, it’s REALLY a concern).

              Not really on the second. As I understand it, the AHCA has a continuous coverage provision, so the preexisting condition issue only comes up if you let coverage lapse for more than two months. Again, that doesn’t mean that *some* people will be affected (i.e., some people will have group coverage, go jobless and insuranceless for more than two months, then have an issue when they get a new job because a preexisting condition will have arisen in the interim), but the numbers we’re talking about probably aren’t enough to be politically significant.

              These are the problems that have always faced the American health care system. A decent majority of people have decent employer-provided insurance (or Medicare), and so the minority of people that don’t face a steep uphill climb against the inertia of everyone else.

      • Derelict

        Not self-employed folks like me. My insurance will likely go from $8,000/year to $24,000 or more. Provided, of course, I can actually get a policy written at all.

        • Denverite

          Yeah, you’re screwed.

      • catclub

        Alaskans get hit about three times harder than the rest of the US, but there are only hints that maybe Murkowski will consider voting against.
        The other senator is probably a lock in favor of it.

        The pitchforks ( and pikes! and tumbrels! ) should really come out for those senators if they vote in favor.

    • jmauro

      Well when you’re base only cares about winning-the-day on cable news that is what you focus on. Consequences of winning aren’t important. Only the win. Even if all your wins are pyrrhic.

    • so-in-so

      I think they assume that Fox and Infowars will keep telling those folks that it’s the Democrats fault (make up any reason you want to explain why).

      Or, they figure they are going to lose votes anyway, but will be able to monkey wrench any attempt to replace their program from a minority position.

      Or that at least one of the two above will work (and they and their donors will have had a few years of tax cuts by then, so WIN!).

    • How do they think the massive increase for premiums for the elderly is going to rebound electorally?

      The elderly will be just that much angrier when they pull the lever for the Republicans?

      • D.N. Nation

        Can vouch that my 70-year-old in-laws are blaming The Blacks, Obama, and Pelosi for Trump not MAGA yet.

        • ExpatJK

          Yeah, I don’t see Trump getting the blame for this, at least from traditional GOPers. Whatever small % of Trump voters were swing voter types might be mad, though.

        • humanoid.panda

          And yet somehow, Trumps approval is in the 30s . I can’t believe that even on liberal blogs , people are still doing the “unless the last retired coal worker in this rural Ohio diner converted, Democrats are doomed” routine …

          • Q.E.Dumbass

            SUCH PWNÈD ALL WE

          • Disapproval is one thing. Voting for the other team is another. Assuming you are on the D side, what would it take for you to vote R?

          • Procopius

            Maybe it’s because the Democratic Party has an approval rating at least five points lower than Trump?

            • Q.E.Dumbass

              [citation requested]

      • cpinva

        “The elderly will be just that much angrier when they pull the lever for the Republicans?”

        I believe this is Einstein’s definition of insanity.

        • And he also thought human stupidity was infinite.

  • ryan.denniston

    Aren’t they not talking to reporters anymore. I thought no one was supposed to talk to reporters.

    • Procopius

      Yes, don’t know how Vox managed to get so many to talk to them.

  • Alex.S

    How do they not have talking points?

    • Hogan

      Those ARE the talking points. There’s nothing actually in the bill that bears mentioning.

  • I read this on Vox and came screaming over here hoping there was a post on it already. My favorite bit right now:

    Jeff Stein
    I want to understand why you think the bill will help the marketplaces.

    Roger Wicker
    For the reasons I’m giving you. A very comprehensive answer, I think.

    • BiloSagdiyev

      Reasons for this legislation have never been made in such detail or with such care.

  • Hondo

    Holy fuck! How do they get away with this shit? I truly don’t understand how policy discussions have devolved to this level of nonsense. Is the republican base that fucking stupid? I know some of these people, and they are not stupid. I just don’t get it.
    And, now after the shooting, we have to listen to republicans lecture us all on how important it is to be civil and show respect. And, of course no democrat will have the balls to publicly call bullshit on them. Who started the scorched-earth politics? In the modern era, we all know it was Gingrich, although we also know it goes back to McCarthy. And the current crop of assholes is continuing the practice. Who’s media sycophants have been spewing hatred, vitriol, race-baiting, and lies impugning the motives and integrity of the other side? It certainly wasn’t Air America. I can’t fucking stand republicans anymore. The smarmy, gaslighting, smug fucking assholes.
    I remember the comment thread that accompanied the NYT article about the White House staffer who was killed while riding in a charity bicycle race in New Mexico. He blew a curve on a mountain road and got hit by a pickup truck. He had a wife and two little girls. The thread was full of hatred. Nasty fucking shit like good, the liberal deserved it, fuck him, along those lines. Saw the same thing on facebook after Mandela died. Who’s side does this? Which public figures encourage that behavior? Is it us? No.
    Biden was on Fresh Air last night. I like him, but he said he respects McConnell and the other side, but I wish Gross would have pressed him a bit on that. Given what the republicans say and do, how can you say that they care about the interests of the country just like everyone else? Looking at their selfish, vindictive, racist policies from crime to health care, to the environment, how can you possibly think they care for anything other than their own money, property and power? Would you have also said that about Stephens after hearing his Cornerstone speech? These people are about the same as him. It is long past the time for democrats to stop tolerating this shit. At some point you have to stand up for yourself, and for the truth. If they don’t have the balls for it, then they deserve to lose.
    On the other hand, it is a bit entertaining to watch McCain and Grassley twist themselves into pretzels like this. They have to hate doing it. It has to leave them a bit embarrassed by it all to think that their life’s work has come to defending indefensible bullshit.

    • CP

      Is the republican base that fucking stupid?

      Yes.

      • FlipYrWhig

        The Republican base may not be _mostly_ that fucking stupid, but they know deep down in their hearts and with ever fiber of their being that the Democrats want to take their stuff and give it to Those People, and they’re not going to stand for that, for damn sure! And this is the overwhelming reason why they are Republicans in the first place, both the stupid and the non-stupid. And they’re not switching. They are hateful, resentful people. They are unreachable. They are a lost cause. Let’s concentrate on outvoting them rather than persuading them of anything.

        • PeteW

          So much this. They are in the minority on almost every issue, but they vote and never waver. Think about it: They voted for Donald f’ing Trump for president! They are a truly a lost cause.

    • so-in-so

      Was that really a question, in reference to people who just recently voted to give Dump the nuke codes? And appear largely to not regret it?

      • Hondo

        I guess I need to clarify. The main confusion for me is how can McConnell get away with this shit and not pay a political price for it, even with the republican base. Whether that cost comes due now or in 2018, even the stupid among the base has to realize that they and their families will lose out when this is done. The charade is simply unsustainable. It has to be.

    • Rob in CT

      Good rant, would read again.

      • Hondo

        Sorry. Got a little carried away during lunch on a slow Friday.

        • Rob in CT

          What? Don’t apologize.

          I was entirely serious. Good rant!

    • Hondo

      Holy shit, I typed who’s instead of whose.

      • BiloSagdiyev

        Fear not. My workplace got a mass email from the front office wih the subject of “Loss cell phone.”

        You’re/your/it’s/its errors when you know better but your fingers are moving at high speed, are quite forgivable. So many worse errors are flying about.

        Now, as the priest said after his congregation tried to repaint the rectory without enough paint and watering it down to stretch it out, “Repaint! Repaint! And thin no more!”

    • cpinva

      “It has to leave them a bit embarrassed by it all to think that their life’s work has come to defending indefensible bullshit.”

      not at all. first, you need to have a sense of shame to feel embarrassed, which they don’t, and second, this is the focus of their life’s work.

    • efgoldman

      And, of course no democrat will have the balls to publicly call bullshit on them.

      I’d call Nancy SMASH! a Democrat. Why, I’d even call her a leading Democrat.
      She ripped the RWNJs and press a new one yesterday.
      http://www.cnn.com/2017/06/15/politics/nancy-pelosi-steve-scalise/index.html

      • BiloSagdiyev

        Ugh. And Chris Cilizza proceeds to step all over his meat with his rented bowling shoes with some Both Sides Do It there.

      • Hondo

        You’re right. She did a pretty good job there and has at other times as well.
        I also see how that POS Cillizza instantly spun it into both sides do it.

  • sibusisodan

    “Why is cutting Medicaid necessary?

    John Boozman

    “I’m not going to argue with you. ”

    Dude, I’m not even sure that rises to the level of non-responsive. If the incompetence wasn’t so terrifying it would be hilarious.

    • CP

      Bubble effect. They live in a universe where it’s simply taken as a given that Medicaid is bad and must be cut, and they can’t be arsed to even explain it to anyone else, because if you need it explained, you’re clearly a Bad Person and not worth talking to.

    • Hogan
  • Davis

    It’s an Abbott and Costello loop. Near the end, I started laughing; “Who’s on first?”

  • Origami Isopod

    FWIW, the AARP is on the warpath. It’d have been nicer if they’d been on the warpath back in October, but it’s better than nothing.