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samsonh

Healthcare reform's impact on Nashville

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I wanted to start a new topic on this since it is very important to one of our city's most vital industries. MLBrumby believes healthcare reform is a bad thing for our city. I believe quite the opposite.

 

MlBrumby:

"Worldview?   More like experience.  The vast bulk of my billable hours comes from the healthcare industry.  I have been interim CEO for several very large HC organizations over the past 10 years, and I know what they are going through now. If you have been reading the news, you would know that there is a tremendous amount of uncertainty in this industry, mostly caused directly by the "Affordable Care Act" (Obama even admitted certain parts are not ready. They never will be ready).  Regarding the link... Someone should explain to you the difference between quarterly (short-term) reports and strategic visions (long-term).  It's no surprise that HCA and other large entities are doing well right now... as they are reaping (in advance) as much cash as they can before the spigot turns.  I was with my friend Bill Gracy (CEO of Blue Cross Blue Shield of TN) last week when he said that costs are about to explode... and companies are trying to make up for that NOW!  That said, the most immediate uncertainty for HCA is what to do with the cash it is earning right now, and (if they are like most other large players) they will use an enormous amount of their capital to purchase their competitors and "grab" as much of new markets as possible.  You may notice that actual hospital construction has slowed tremendously (because those are long term commitments).  So just saying something to try to make it happen is not my stock in trade... it's what I know."

 

I will address my points by number so they are easier for you to address if you wish:

 

1. If Bill Gracey says 'healthcare costs are about to explode' he speaks from a completely different point of view than hospital companies. He is on the payer side. Companies like HCA and CYH and LPNT certainly wouldn't mind if more procedures are covered because they are getting paid for them.

 

2. If HCA invests in long term projects it will have very little impact on short term EPS simply because of the nature of accounting. Investments in long term fixed assets are depreciated over their expected lifetime. I have no idea what you mean that HCA is 'reaping as much cash as possible before the spigot turns'. This comment makes zero sense when you consider how GAAP accounting works. I mean zero sense at all.

 

3. If we look at HCA's financial we can see they spent 1.862 billion on CapEx in 2012. They spent 1.679 in 2011. They spent 1.325 in 2010. This alone disproves the point about not investing in the future that you were trying to make. one would think that if HCA thought their business was dying they would be spending less, but instead they are spending more to try to attract more consumers. Interesting...

 

4. If the hospital industry was dying why would Tenet spend such a large premium to buy Vanguard? VHS was trading around 12.50 when THC offered 21 a share. That is a premium of nearly 70%. Why would THC buy a dying business for a 70% premium? The reason companies buy competitors is because they see an opportunity for synergy and their cost of capital is lower than the potential return. Simple math. Companies do not seek to expand into new markets if they will lose money.

 

5. If hospitals were going to suffer because of the ACA, why would the delay of implementation hurt them. http://www.modernhealthcare.com/article/20130703/NEWS/307039965/reform-update-for-profit-hospitals-take-hit-as-acas-employer-mandate

 

6. Markets apparently believe health care reform will be good for health care companies, as HCA, CYH, LPNT, VHS, AMSG, and HWAY are up 29.5%, 41.7%, 34.8%, 70.8%, 32%, and 55.7% respectively. IF the ACA is bad for Nashville I will take bad legislation ALL DAY LONG.

 

7. As Dmills noted, the companies moving into WES have very little to do with the ACA anyway. In fact one would think the ACA would help Parallon as they help hospitals become more efficient.

 

 

 

I understand you do not care the ACA. But factually it is a great piece of legislation for this city. I really don't believe that fact can be argued. You have second hand stories of why it is a bad piece of legislation. I have numbers and facts and stats. I'll let others read both sides and make up their mind.

Edited by samsonh

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Government has no business being in the healthcare field. What you call "reform" isn't reform, it's control. The only thing federal control of healthcare will serve to do, as it always does, is drive up costs, drive down quality, and increase rationing (not to mention, and most dangerously, likely slow or decrease the number of individuals choosing to become doctors). The left needs to just halt this pathological need to try to control everything that is none of their business.

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Government has no business being in the healthcare field. What you call "reform" isn't reform, it's control. The only thing federal control of healthcare will serve to do, as it always does, is drive up costs, drive down quality, and increase rationing (not to mention, and most dangerously, likely slow or decrease the number of individuals choosing to become doctors). The left needs to just halt this pathological need to try to control everything that is none of their business.

Seriously flawed thinking, that is why the US is lagging behind in everything.....including healthcare.

1069870_690756130951037_1384482559_n.jpg

Edited by producer2

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Samsonh did his homework. Thanks for moving this to the coffeehouse and numbering the points.  I only have a few minutes, but I can address most. 

 

BTW: The spigot reference is to the revenues that will certainly diminish under Obamacare, as its own stated goal is to control costs (how do you think that will happen? One, or both, of two ways, reducing services or reducing ). And don't be fooled into thinking that the payers and delivery systems aren't on the same page with respect to fees.  Both "sides" know fully and completely that they better get their rate increases right now while the "getting is good". In fact, as has been practice for decades, these fees are negotiated. 

 

Okay...

 

1.  Re: Gracy comments (see above).

2.  Re: GAAP accounting vis-a-vis Capex: Your reference to GAAP notwithstanding, you did not explain your counter to the spigot. GAAP refers to accounting, as opposed to strategic management, and I am speaking almost exclusively with respect to strategy, as that's where virtually all macro-economic government policies have their direct impact. 

3.  Re: Short term (OpEx) vs. Long term (CapEx)... you dispute yourself here to your point 2.  Let me see if I can make this as simple as possible.  Taking the previous 2-3 years of CapEx does not (at all) prove future trends.  As most large orgs do their planning for such expenditures well in advance. As we've already seen wrt Short term expenses (just ask Vanderbilt), the long term cuts are coming!!  Just by their nature (LONG TERM), they take longer to adjust to market conditions.  Even with that point made, I remind: SCOTUS didn't even give their ruling on Obamacare and the new taxes associated with it until June 2012. Now that it is the law of the land (Obama's executive orders notwithstanding), trust me (oh, trust me!!)  those capital projects are being reevaluated... and many will be cut completely. 

4.  I never said the "industry was dying"... it's dealing with uncertainty.  Don't change the subject!  You cannot dispute that it is dealing with increased uncertainty due in great measure to Obamacare.  That's a fact that no one in the industry disputes. Despite your assertion, go back to my original comments and you will see exactly what is happening in the industry (like consolidation on steroids).  The ultimate effect of this could possibly help Nashville's healthcare industry (Long term), but it is also at risk of being reduced to irrelevancy if the progression continues toward single-payer (then Washington DC will be the nation's healthcare hub). Personally, I doubt the consolidation will do any good to the entrepreneurial environment that has been fostered by the existence of healthcare talent in Nashville.  We have seen it in energy and manufacturing, and the new federal regs will lead to a one-size-fits-all approach to healthcare and restrict innovation (and by extension choke new businesses).  No doubt, there will be continued consolidation as larger entities acquire orgs in new markets or 

5.  Re: "Delay of implementation"... Once again, this is a direct result of the uncertainty injected by Obamacare. But putting that aside for a moment, you keep using short term facts/evidence to support your counter to my firm belief that Obamacare will damage the industry, and very likely the status that Nashville enjoys as a premier center in the industry.  That recognition has come from private healthcare, and the whole idea behind Obamacare is to put the industry on the public's dime (sts). Strategic planning is virtually impossible when the regs are shifting from day to day.  That's what Obama and the Democrats don't seem to know (or care about).  And by the way, when government runs the show, the people in government have no incentive to care about the consequences of their bad laws... until the s**t hits the fan. And that is what Obama has been trying to avert with his latest executive order. 

6.  Re: Stock prices of private health companies:  Um, short term vs. long term again (not convinced you understand the difference).  As my good friends used to like to say during the Bush administration: "The stock market is not a good gauge of the economy".  Well, the stock market (short term) is not a good gauge of the future of healthcare under Obama.  Look, common sense alone will tell you that efficiencies and cost-control don't come from increased government involvement.  There is no example of that happening... ever!  And if you look closely enough, you will already see the effects of Obamacare on the private sector.  

7.  Re: SCRI and Parallon:  Dmills has made the best argument to my original points.  However, these organizations are in large measure funded by HCA (hence, subsidiaries).  Time will tell how these entities will fare under Obamacare.  Then again, this is the crux of my speculation (it's purely speculative).  I made it based on my experience and I truly think there are things behind the scenes that are causing this delay... other than what Nevin wrote last week being financial.  We will see.

 

You are absolutely correct that I do not think Obamacare will lead to improved care and/or increased coverage (its stated goals).  Even the latest push by Obama and Hollywood celebs is an attempt to "drive" more people currently paying out of pocket for their healthcare to higher premiums under Obamacare, and it's a tacit admission of an early failure. And yes, the immediate impact of the law will (appear to) help the large Nashville companies, and some startups as a result of opportunities they may see from the forced changes of government regulation.  Let's at least agree that healthcare will not be made more efficient under Obamacare... unless you think the DMV and all the other bureaucracies from the DC to Nashville are more efficient. And let's not even go to the bad faith the bureaucrats and politicians have already shown with very sensitive personal information.  

 

All in all Samsonh, you have not addressed the points made about short-term vs. long-term view of healthcare management and the chasm that results from uncertainty (both structural and systemic).  You reference something about GAAP, but ignore completely the whole impact on strategic management made in the first place.  Remember folks... it's all about uncertainty.  And Obamacare has injected an enormous amount of uncertainty into the industry.  

 

I understand your unconditional love for Obama, but your emotional stakes here cannot change the effects of the ACA.  It will (already has) have a negative effect on the industry. That is what you are disputing (not anything about the WES), and I simply think you haven't made your point that Obamacare will be good for Nashville.  I think it will be bad.. and I have my own experience and common sense to base that on. Not emotions!

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Seriously flawed thinking, that is why the US is lagging behind in everything.....including healthcare.

1069870_690756130951037_1384482559_n.jpg

 

So would that be Detroit on the left?

Government has no business being in the healthcare field. What you call "reform" isn't reform, it's control. The only thing federal control of healthcare will serve to do, as it always does, is drive up costs, drive down quality, and increase rationing (not to mention, and most dangerously, likely slow or decrease the number of individuals choosing to become doctors). The left needs to just halt this pathological need to try to control everything that is none of their business.

 

Sometimes FMJ, common sense is neither common or sensible.  Hence, the cartoon picture posted in reply to your post. Interesting that a union hall replaces a church. 

Edited by MLBrumby
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So would that be Detroit on the left?

 

Sometimes FMJ, common sense is neither common or sensible.  Hence, the cartoon picture posted in reply to your post. Interesting that a union hall replaces a church. 

it's metaphorical. Not too hard to grasp if you try...

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Seriously flawed thinking, that is why the US is lagging behind in everything.....including healthcare.

1069870_690756130951037_1384482559_n.jpg

 

I remember when somebody posted this caricature on another website I'm on. It spawned considerable laughter. Truly an example of cognitive dissonance when it comes to ideological management of cities. Since you consider this a serious response to my comments, demonstrating a thorough absence of an actual substantive counter-argument, I will presume you concede my point in its entirety.

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Not really a concession, just more of a view of how far apart we are. Since I don't agree with your thoughts debating them is really a nowhere proposition. 

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Just out of curiosity, how old a person are you, P2 ? Who instructed you in your ideological standpoint ? Where did you learn it ? The irony of the left is that they paint themselves as tolerant and open-minded and willing to listen to other viewpoints. Of course, in reality, I know them to be rigidly intolerant of other viewpoints to the point of violent, unhinged and reactionary behaviors (or because they cannot justify their views in the face of stark reality, take their shovel and pail and go home -- the latter of which you are employing).

 

I posted a debate point. How about discussing why you disagree. Post examples of where I am wrong and where heavy-handed left-wing government control of healthcare is a rousing success. P.S. Please don't use examples of racially homogenous and upper-income nations with low-crime rates and a smaller population than Tennessee. I mean nations with a heterogeneous population and a substantial underclass with high unemployment, many of whom believe and are told by their leaders they are entitled to be permanently supported by those that work. Where are the great, successful examples of such countries and those that we are "lagging so far behind" in ?

Edited by fieldmarshaldj
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I am 55 years old, born and raised in Louisville KY in a conservative household. I have voted Republican far more than Democrat over the years but not so much recently. I have been very blessed to have had the opportunity to travel all over the world (except Asia) and spent time in places like Russia and Istanbul just to name a few extremes. I don't think any one nation has a true perfect utopia but i am confident that many are doing some things better than we are.

 

I am probably more of a Centrist than anything else so statements like this:

The irony of the left is that they paint themselves as tolerant and open-minded and willing to listen to other viewpoints. Of course, in reality, I know them to be rigidly intolerant of other viewpoints to the point of violent, unhinged and reactionary behaviors (or because they cannot justify their views in the face of stark reality, take their shovel and pail and go home -- the latter of which you are employing)."

That does not really lend itself to me actually giving a crap about what your thinking is. 

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I am 55 years old, born and raised in Louisville KY in a conservative household. I have voted Republican far more than Democrat over the years but not so much recently.

 

I'm surprised, I thought you were at least 30 years younger. Of course, being raised in a "Conservative household" is no indicator of necessarily how one will turn out (after all, Hillary Clinton was alleged to have been), though some are in perpetual rebellion against such a "restrictive" environment. One would think some would grow out of such a rebellion, but the old adage about with age comes wisdom is certainly far from the reality.

 

I have voted Republican far more than Democrat over the years but not so much recently.

 

Also not much of an indicator, given how in love the Republican party has become with big government statism, at least the establishment leadership. I figure their lurch to the left isn't enough to satisfy your appetite ?

 

I have been very blessed to have had the opportunity to travel all over the world (except Asia) and spent time in places like Russia and Istanbul just to name a few extremes. I don't think any one nation has a true perfect utopia but i am confident that many are doing some things better than we are.

 

Well, I do applaud Russia for standing up to sexual extremists as of late. Given that their former incarnation worked mightily to destabilize our country via political and social extremism, they certainly know such a formula is not a workable method for the long term. However, you did say "we" were lagging behind in "everything." You've failed to cite these shining examples of success elsewhere where your left-wing ideology has elevated a nation. Of course, this was the same rhetorical hyperbole others on your side cited attacking Tennessee's legislature as the "worst" in the country while failing to cite what were the best. It's why the arguments of your side simply don't hold water.

 

I am probably more of a Centrist than anything else so statements like this:

 

Well, you can call yourself whatever you like, but your comments and rhetoric are crystal-clear.

 

" The irony of the left is that they paint themselves as tolerant and open-minded and willing to listen to other viewpoints. Of course, in reality, I know them to be rigidly intolerant of other viewpoints to the point of violent, unhinged and reactionary behaviors (or because they cannot justify their views in the face of stark reality, take their shovel and pail and go home -- the latter of which you are employing)."

 

That does not really lend itself to me actually giving a crap about what your thinking is.

 

And by that, you've fallen back to demonstrating my prior point of a hostile reaction to differing viewpoints. You still have yet to enunciate any coherent or logical arguments to support your points at all. So far, all I've learned is your age, your birthplace, that you've travelled to foreign locales, but I have yet to see from you coherent arguments in favor of government control of healthcare, examples of where it has been successful with our demographics and pathology, just essentially knee-jerk hyperbolic statements with nothing to justify them, posting pictures of ludicrously debunked posters in place of logical argument, and an increasing level of hostility for doing nothing more than pointing out the aforementioned points.

 

What was your purpose of even posting in this thread if you weren't interested in serious discussion ? It was, after all, begun by a poster of the left who wished to have a discussion of the issue.

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Here is my argument and its quite simple. It's called the electorate and it has been very apparent that the more the fractured right talks the further behind they get. When we have real history on the affordable care act then we can make observations. If Haslam does not allow this to have an opportunity to work in some form, then all we have is obstruction once again and speculation on what the outcome could be.

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That's not an argument, that's a meaningless Democrat talking point. What does the electorate have to do with supporting your position ? The majority does NOT want the federal government in charge of their healthcare. You have systematically failed to give any successful example of a federal government controlled healthcare with our population and demographic dynamics. You have stated we as a nation are behind everyone else ? Whom are we behind ?

This abomination of a system FORCED upon the nation by one party (of whom didn't even READ the bill -- remember, "We have to pass it to know what's in it ?" made by the infamous Speaker Pelosi) with no input or concern for the other side. There's only one apt word to describe this, and that's fascism. We don't need to fast forward to the future to know if it will work, as it has already failed now and completely. Just wait and see all those political fence-sitters who thought it MIGHT be a good idea start to see it hit them in the pocketbooks and transmogrify into an even more disastrous version of the UK's Kafkaesque system.

 

I applaud Haslam for standing up to this madness, and I hope he continues to obstruct government-sanctioned fascism from now until this insanity is destroyed once and for all.

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Obamacare is essentially a conservative program.  I think the framework was first proposed by the Heritage foundation, if I'm not mistaken, and prior to Obama, such an idea was most notably promoted by Republicans like Bob Dole and Mitt Romney.  Granted, these kinds of policies may not be as 'conservative' as some would like, they were Republican ideas nonetheless.  As I recall, most of the 'left' wanted a single-payer system and were disappointed that Obamacare was the best they could get.

 

Is there a good chance that Obamacare falls short of it's aspirations?  Absolutely.  This kind of undertaking is no small task, to be sure.  Additionally, those who oppose Obamacare continue to deliberately undermine it's implementation and highlight anything that could arguably be used to paint the new law in a bad light, which doesn't help to say the least.

 

Very few people would argue that Obamacare is a perfect law.  In fact, no such law of any kind comes to mind.  The question then becomes, how can you work to make Obamacare better and what can be changed to ensure the transition and implementation are as smooth as possible?  Instead, the response seems to be apocalyptic predictions about the future of health care in this country, 39 dead-end votes to repeal, and not a single, viable alternative solution that addresses the problems with our health care system that Obamacare is attempting to rectify. 

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Obamacare is essentially a conservative program.  I think the framework was first proposed by the Heritage foundation, if I'm not mistaken, and prior to Obama, such an idea was most notably promoted by Republicans like Bob Dole and Mitt Romney.  Granted, these kinds of policies may not be as 'conservative' as some would like, they were Republican ideas nonetheless.  As I recall, most of the 'left' wanted a single-payer system and were disappointed that Obamacare was the best they could get.

 

Is there a good chance that Obamacare falls short of it's aspirations?  Absolutely.  This kind of undertaking is no small task, to be sure.  Additionally, those who oppose Obamacare continue to deliberately undermine it's implementation and highlight anything that could arguably be used to paint the new law in a bad light, which doesn't help to say the least.

 

Very few people would argue that Obamacare is a perfect law.  In fact, no such law of any kind comes to mind.  The question then becomes, how can you work to make Obamacare better and what can be changed to ensure the transition and implementation are as smooth as possible?  Instead, the response seems to be apocalyptic predictions about the future of health care in this country, 39 dead-end votes to repeal, and not a single, viable alternative solution that addresses the problems with our health care system that Obamacare is attempting to rectify. 

 

It's essentially WHAT ? Conservative ? You have a truly bizarre notion of Conservatism, sir. No Conservative supports such a system of heavy-handed government fascism-socialism. Democrats, with huge majorities in Congress, were free to pass whatever abomination they wanted, and did just that, so this claim that it was a "Conservative" version is ludicrous. As for Romney, he was an infamous Socialist in his governance of Massachusetts, and his leadership so disastrous that he ran away from running for a second term. I could certainly state that he could largely take credit for getting the ball rolling on this mess, a premier example of the left-wing Republican establishment being as disinterested in shrinking government as their Democrat allies (although even they found this fiasco too far a bridge to cross). This was one key reason I consistently refused to support him, either in the 2008 and 2012 primaries, and in the 2012 general. His running for President against a man he scarcely differed from ideologically made him a bonafide "ringer."

 

How you ensure to make healthcare better is simple. Defund this anti-freedom abomination, get the federal government the hell out of health care and return it to the purview of individuals where it belongs. Unaccountable government bureaucrats have no business making decisions for us.

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That's not an argument, that's a meaningless Democrat talking point. What does the electorate have to do with supporting your position ? The majority does NOT want the federal government in charge of their healthcare. You have systematically failed to give any successful example of a federal government controlled healthcare with our population and demographic dynamics. You have stated we as a nation are behind everyone else ? Whom are we behind ?

This abomination of a system FORCED upon the nation by one party (of whom didn't even READ the bill -- remember, "We have to pass it to know what's in it ?" made by the infamous Speaker Pelosi) with no input or concern for the other side. There's only one apt word to describe this, and that's fascism. We don't need to fast forward to the future to know if it will work, as it has already failed now and completely. Just wait and see all those political fence-sitters who thought it MIGHT be a good idea start to see it hit them in the pocketbooks and transmogrify into an even more disastrous version of the UK's Kafkaesque system.

 

I applaud Haslam for standing up to this madness, and I hope he continues to obstruct government-sanctioned fascism from now until this insanity is destroyed once and for all.

You, like most who think like you are delusional. It's only a matter of time.....

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You, like most who think like you are delusional. It's only a matter of time.....

 

No arguments from your side (despite my giving you ample opportunity to present them), just talking points, joke posters and reactionary hyperbole. At least my side "thinks." You can't even make a defense of your own ideology and a case for federal government control of healthcare. I hope you at least got your "free" ObamaPhone for your efforts.

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It's essentially WHAT ? Conservative ? You have a truly bizarre notion of Conservatism, sir. No Conservative supports such a system of heavy-handed government fascism-socialism. Democrats, with huge majorities in Congress, were free to pass whatever abomination they wanted, and did just that, so this claim that it was a "Conservative" version is ludicrous. As for Romney, he was an infamous Socialist in his governance of Massachusetts, and his leadership so disastrous that he ran away from running for a second term. I could certainly state that he could largely take credit for getting the ball rolling on this mess, a premier example of the left-wing Republican establishment being as disinterested in shrinking government as their Democrat allies (although even they found this fiasco too far a bridge to cross). This was one key reason I consistently refused to support him, either in the 2008 and 2012 primaries, and in the 2012 general. His running for President against a man he scarcely differed from ideologically made him a bonafide "ringer."

 

--Right.  Obamacare may not be a very "conservative" idea, but much of the framework/thinking behind it (individual mandate, etc.) was devised and supported by Republicans (Gingrich, Heritage, Dole, Romney).  I will concede that any/all of them may not qualify as "conservative" and instead they may in fact be fascist/socialist/Rino's.  In any case, as I mentioned, most of the left supported a single-payer system, so Obamacare was a compromise for them, too.  It's the plight a two-party democratic-republic

 

 

How you ensure to make healthcare better is simple. Defund this anti-freedom abomination, get the federal government the hell out of health care and return it to the purview of individuals where it belongs. Unaccountable government bureaucrats have no business making decisions for us.

 

--This statement reminds me of the signs I've seen in pictures of Tea Party rallies that read, 'Keep Your Government Hands off of my Medicare!!!', etc.  Do you want government out of health care entirely, or do you just not like extending coverage to everyone?  I agree that unaccountable govt. bureaucrats have no business making decisions for us.  What part of Obamacare makes you believe this will happen? 

 

 

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--Right.  Obamacare may not be a very "conservative" idea, but much of the framework/thinking behind it (individual mandate, etc.) was devised and supported by Republicans (Gingrich, Heritage, Dole, Romney).

 

Again, there's nothing "Conservative" about Obamacare. I know the problem when you're dealing with ideological Marxists that anything not up to snuff is Conservative (hence a "Socialist" bill would be "Conservative" to a Democrat). Government involved in healthcare is not Conservatism at all.

 

"I will concede that any/all of them may not qualify as "conservative" and instead they may in fact be fascist/socialist/Rino's.  In any case, as I mentioned, most of the left supported a single-payer system, so Obamacare was a compromise for them, too.  It's the plight a two-party democratic-republic."

 

There was no "Two parties" involved in ObamaCare. It was one party. Forced down the public's throat regardless of the fact that a majority does NOT want it. The party that shoved it down the public's throat did not even read the bill, the Speaker herself at the time, Pelosi, did not read it. I don't know about you, but I certainly would not vote in the affirmative on a bill I did not read.

 

--"This statement reminds me of the signs I've seen in pictures of Tea Party rallies that read, 'Keep Your Government Hands off of my Medicare!!!', etc.  Do you want government out of health care entirely, or do you just not like extending coverage to everyone?"

 

I stated plainly the federal government needs to be entirely out of the healthcare business (and that's just the tip of the iceberg). It has gone so far beyond its Constitutional mandates. We are rapidly headed towards $20 trillion in debt and way beyond that in unfunded mandates. This is ideological madness and a formula for destroying this country. Of course, I know that is what the goal of the left is. In order to remake the country in their utopian (dystopian) vision, it must first be destroyed. Your Emperor is doing a magnificent job.

 

"I agree that unaccountable govt. bureaucrats have no business making decisions for us.  What part of Obamacare makes you believe this will happen?"

You agree, yet you support precisely that. What part of this do I believe makes me believe this will happen ? It's a GOVERNMENT program !

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It's essentially WHAT ? Conservative ? You have a truly bizarre notion of Conservatism, sir. No Conservative supports such a system of heavy-handed government fascism-socialism. Democrats, with huge majorities in Congress, were free to pass whatever abomination they wanted, and did just that, so this claim that it was a "Conservative" version is ludicrous. As for Romney, he was an infamous Socialist in his governance of Massachusetts, and his leadership so disastrous that he ran away from running for a second term. I could certainly state that he could largely take credit for getting the ball rolling on this mess, a premier example of the left-wing Republican establishment being as disinterested in shrinking government as their Democrat allies (although even they found this fiasco too far a bridge to cross). This was one key reason I consistently refused to support him, either in the 2008 and 2012 primaries, and in the 2012 general. His running for President against a man he scarcely differed from ideologically made him a bonafide "ringer."

 

How you ensure to make healthcare better is simple. Defund this anti-freedom abomination, get the federal government the hell out of health care and return it to the purview of individuals where it belongs. Unaccountable government bureaucrats have no business making decisions for us.

My friend fieldmarshaldj does not want the government bureaucrats making decisions for us, but he does not mind the free-market-profit-making healthcare companies doing the same. 

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Oh noes ! Profit ! Free market ! Private sector ! Oooga booga !

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Healthcare should not be for profit. Healthcare is a right, not a privilege.

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Oh noes ! Profit ! Free market ! Private sector ! Oooga booga !

I prefer doctors and patients making decisions, not healthcare company CFO's and accountants.

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Healthcare should not be for profit. Healthcare is a right, not a privilege.

 

If the government had declared healthcare a right back in 1776 and set up a government-run system, we'd still be treating the sick with barbers bleeding patients. Free markets drive innovation, encourage competition and drive costs down. Government heavy-handedness encourages dysfunction, drives up costs, drives down quality. If you love the smoothness and efficiency of the DMV, you'll love ObamaCare.

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What we really love is democracy and right now democracy is winning.....

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