A few weeks ago President Trump was all excited by the idea that the entire legislation would be found illegal -- funny how Trump loves activist judges when it favor's his desired outcome, and that the entire law would, in fact, be unconstitutional. This, of course, is the result of the GOP Congress stripping out a specific aspect of the Obamacare legislation.
Imagine his disappointment when the GOP refused to carry the water for the President -- and indicated that they had no plan, no timetable, no ideal or even analysis of what the future of healthcare should look like. For Trump the objective was (a) remove Obamacare -- and destroy Obama's legacy, (b) get someone to do something about healthcare that was "cheap and great". That's the sum total of the White House's contribution to the debate.
What is clear is that after the massive tax cut that took place in 2018 -- and yes the reality of lower reimbursements is partly the result of less retention at the source. The fiscally responsible GOP (I know they are there somewhere) will have to cut expenses. So far there has been a massive increase in military spending which leaves two sectors to cut: Social Security and Medicaid/Medicare. The biggest item is Social Security but there's not much room there for cutting -- manly because SS is funded directly from payroll deductions and by a Trust Fund. Following changes to the Trust fund funding, it will be solvent until at least 2032. For the sake of amusement, let's assume that it can be further tweaked so that its fully funded until 2060 -- which would be a very good outcome.
Part of the problem is that the easy fix for SS is to reduce payments...and that would attack a key constituency of the GOP. Granny will not vote for you if you cut her SS check by 20%. The next big thing is healthcare. That's really the only place where cuts could take place, really it's the only item. The GOP/Trump's idea is that a private healthcare system that looks very much like the current system could see system-wide cuts by 50%. In fact, the objective for the US government should be to cut healthcare cost from 15% of GDP to 7% of GDP -- in line with the rest of the OECD...yep US healthcare cost is nearly twice the average of the OECD.
Currently, Medicare/Medicaid cost about $1,000 billion per annum (60/40) then there is another $600 billion which is mandatory: food stamps, child tax credit, unemployment benefits and pension for the civil servants, military & cost guards.
Part of the problem of cutting healthcare cost is that for the GOP the only solution that seems to work is the one it will never embrace -- universal healthcare. There are variants such as the Singapore model, but it requires drastic action on the part of the government and citizen's saving habits; in Singapore, nearly 30% of salary is paid into individual funds that can be used for very restricted use -- such as health care. Moreover, Singapore has a government-funded "catastrophic" event system that is fully funded by the government but where part of these forced savings are used up using a complex equation.
Imagine the US government trying to force Americans to save... it's just unconstitutional and against the American way.
The result of all these issues (especially the fact that universal healthcare is the cheapest) means that the GOP is forever looking for a magic solution "cheaper and better" that doesn't force Americans to save, restrict their choices.
Still looking for the new wheel...but don't hold your breath because let's be clear here. Obamacare that was invented in Massachusetts was an invention of the GOP before it was appropriate by Obama and the Democrats
Imagine his disappointment when the GOP refused to carry the water for the President -- and indicated that they had no plan, no timetable, no ideal or even analysis of what the future of healthcare should look like. For Trump the objective was (a) remove Obamacare -- and destroy Obama's legacy, (b) get someone to do something about healthcare that was "cheap and great". That's the sum total of the White House's contribution to the debate.
What is clear is that after the massive tax cut that took place in 2018 -- and yes the reality of lower reimbursements is partly the result of less retention at the source. The fiscally responsible GOP (I know they are there somewhere) will have to cut expenses. So far there has been a massive increase in military spending which leaves two sectors to cut: Social Security and Medicaid/Medicare. The biggest item is Social Security but there's not much room there for cutting -- manly because SS is funded directly from payroll deductions and by a Trust Fund. Following changes to the Trust fund funding, it will be solvent until at least 2032. For the sake of amusement, let's assume that it can be further tweaked so that its fully funded until 2060 -- which would be a very good outcome.
Part of the problem is that the easy fix for SS is to reduce payments...and that would attack a key constituency of the GOP. Granny will not vote for you if you cut her SS check by 20%. The next big thing is healthcare. That's really the only place where cuts could take place, really it's the only item. The GOP/Trump's idea is that a private healthcare system that looks very much like the current system could see system-wide cuts by 50%. In fact, the objective for the US government should be to cut healthcare cost from 15% of GDP to 7% of GDP -- in line with the rest of the OECD...yep US healthcare cost is nearly twice the average of the OECD.
Currently, Medicare/Medicaid cost about $1,000 billion per annum (60/40) then there is another $600 billion which is mandatory: food stamps, child tax credit, unemployment benefits and pension for the civil servants, military & cost guards.
Part of the problem of cutting healthcare cost is that for the GOP the only solution that seems to work is the one it will never embrace -- universal healthcare. There are variants such as the Singapore model, but it requires drastic action on the part of the government and citizen's saving habits; in Singapore, nearly 30% of salary is paid into individual funds that can be used for very restricted use -- such as health care. Moreover, Singapore has a government-funded "catastrophic" event system that is fully funded by the government but where part of these forced savings are used up using a complex equation.
Imagine the US government trying to force Americans to save... it's just unconstitutional and against the American way.
The result of all these issues (especially the fact that universal healthcare is the cheapest) means that the GOP is forever looking for a magic solution "cheaper and better" that doesn't force Americans to save, restrict their choices.
Still looking for the new wheel...but don't hold your breath because let's be clear here. Obamacare that was invented in Massachusetts was an invention of the GOP before it was appropriate by Obama and the Democrats
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