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cartoon of romney and obamacare

Jimmy Margulies via politicalcartoons.com

Here's an essay by Sen. Bill Frist (R-TN, retired) that encapsulates the problem Republicans will have in trying to block the expansion of health care insurance for those who are not insured. Writing in The Week:  

Why both parties should embrace ObamaCare's state exchanges

Largely lost in the fight over ObamaCare is a worthy provision that lets states develop insurance systems that are right for them — but they must act soon

posted on July 18, 2012

While you may remember Bill Frist as an ex-majority leader in the Senate during the Bush years, don't forget this part of Frist's resume:
He is a fourth-generation Tennessean. His great-great grandfather was one of the founders of Chattanooga, Tennessee, and his father was a doctor and founded the health care business organization which became Hospital Corporation of America. Frist's brother, Thomas Jr., became chairman and chief executive of Hospital Corporation of America in 1997.
Have any doubts that Frist is aiming at GOP governors? Here's what he pointedly says:
Enacting some sort of exchange establishment legislation is expected to be crucial to receiving federal approval for a state-run exchange. And though some GOP governors refuse to set up an exchange of their own, I see little advantage for states to default to the federally designed, one-size-fits-all exchange when they can design and run their own.  
On the one hand there will be political pressure to avoid any cooperation at all. This effort (pdf), for example, is a letter from Republican members of Congress encouraging governors to avoid any cooperation with state exchanges.

(Continue reading below the fold.)

On the other hand, hospitals will put a tremendous amount of pressure on governors in every state (not just blue ones) to go forward with health reform. And there will be powerful lobbyists with good political connections like Frist who will be doing the pushing. Here's another example of that:

And hospitals in opt-out states would still get hit with cuts programmed in the law under the assumption that every state would take the Medicaid expansion and fewer uninsured people would be needing charity care.

"You are still paying for that coverage expansion but not getting the benefit of it," said Herb Kuhn, president of the Missouri Hospital Association. "So you as a state are exporting your dollars to another state. If you have some adjoining state that accepts (the Medicaid expansion) then you are basically sending your dollars to your neighbor."

How might hospitals be helped? The obvious way is insurance expansion. There are two main ways the underinsured can be helped: expansion of Medicaid, and the use of state insurance exchanges. This handy calculator from Kaiser Family Foundation maps those effects (in my Northeast area, 12 percent of the non-elderly population could benefit from the ACA coverage expansions. The map shows a disproportionate concentration of higher percentages in red states—the database is searchable by zip code).
table of % of uninsured in hospitals
Catherine G. McLaughlin and Karoline Mortensen, Health Affairs


How does that affect hospitals? This table (article from Health Affairs, 2003) shows the estimated share of discharges for uninsured patients, generally around 5 percent on average, but with a huge range:
While the average share of uninsured inpatient discharges is 4.8 percent, the average share for the top decile of hospitals—that is, those with the highest shares—was 14.6 percent, with individual hospitals ranging from 8.6 percent to 43.3 percent.
Who pays for those who can't pay? You do, one way or the other, be it higher insurance rates or tax money in some fashion.

The result is dialogue like this:

"I will not be party to socializing health care and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government," Texas Gov. Perry said last week. About one-fourth of Texas residents are uninsured, the highest percentage of any state.

But John Hawkins, top lobbyist for the Texas Hospital Association, says his group isn't dropping the subject.

"We have told the governor we are willing to continue the discussion," said Hawkins. "It's hard to imagine how you get from here to there without accessing federal funds at some level."

Bill Frist's lobbying effort is just the tip of the iceberg, and it is unclear how long the Republicans will be able to fight reality and stonewall reform.

In fact, I suspect the answer is not "forever."

Originally posted to Daily Kos on Sun Jul 22, 2012 at 06:00 AM PDT.

Also republished by Southern Action, Three Star Kossacks, and Nashville KosKats.

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Comment Preferences

      •  Right you are, HCA has alot to gain (16+ / 0-)

        That's why I think alot of this resistance will melt away.
        There is too much socialist money involved for all the capitalists to take.

        Today's problems are yesterday's solutions. Don Beck

        by Sherri in TX on Sun Jul 22, 2012 at 06:36:25 AM PDT

        [ Parent ]

        •  A Point That I've Picked Up, At Least For Texans (9+ / 0-)

          ...is that state law requires counties to provide payment for medical services, up to certain percentage of their budget, for the uninsured. In my county $3.6M are set aside to pay over to medical providers for care provided to uninsured indigents not otherwise covered by other means. As much as the white-right rails against property taxes, and resents paying them, this cuts to the core. Embracing Obamacare would reduce our county taxes by 5% (if you're a winger), or free the money up for critical services (if you're a progressive).

          "Force is as pitiless to the man who possesses it, or thinks he does, as it is to its victims; the second it crushes, the first it intoxicates.” Simone Weil

          by chuco35 on Sun Jul 22, 2012 at 07:30:32 AM PDT

          [ Parent ]

        •  They keep wishing it would melt away. (5+ / 0-)
          Recommended by:
          howd, BigOkie, cocinero, NWTerriD, glitterscale

          I truly believe that the powers that be in the GOP wish this would all go away.  They love the ACA as a whipping boy, but they know how helpful it will be to state budgets and how overturning it places a huge problem squarely on their shoulders. Right now it is very useful as a get out the vote tool for the teabaggers, but after the election, it will be allowed to melt away...exactly for the reason you mentioned.  There's money to be made!  Soon a different shiny object will be found to wave in front of the faithful...to make them angry and afraid.

          Got Social Security? Thank a Democrat!

          by Fury on Sun Jul 22, 2012 at 08:33:56 AM PDT

          [ Parent ]

        •  Then why wouldn't Rick Scott.... (0+ / 0-)

          ....be for it?  It would be a giant windfall for him and his buddies....

          9-11 changed everything? Well, Katrina changed it back.

          by varro on Sun Jul 22, 2012 at 12:25:23 PM PDT

          [ Parent ]

      •  exactly (7+ / 0-)

        the difference between the health care reform project that Hillary headed up and this one is that Hospitals and the health care industry (as well as insurers) are on the side of reform this time around.  

        The GOP demonization machinery has a harder row to till because of this. Hospitals and insurers are part of the reform process, not in opposition to it.

        Hospitals want this because they know who broken the old system is.

        Words can sometimes, in moments of grace, attain the quality of deeds. --Elie Wiesel

        by a gilas girl on Sun Jul 22, 2012 at 07:13:52 AM PDT

        [ Parent ]

        •  My community's hospital "writes off", ie passes... (6+ / 0-)
          Recommended by:
          ZedMont, stitchmd, Fury, BigOkie, cocinero, Mokurai

          ...on to those who have insurance, $77M of "free" services every year. That's how much we would lose every year if Perry's ideology prevails.

          "Force is as pitiless to the man who possesses it, or thinks he does, as it is to its victims; the second it crushes, the first it intoxicates.” Simone Weil

          by chuco35 on Sun Jul 22, 2012 at 07:36:59 AM PDT

          [ Parent ]

          •  the health system I work for (2+ / 0-)
            Recommended by:
            cocinero, Mokurai

            In Central Oklahoma writes off a similar amount every year as well.  One big beef I have with the hospital associations and insurers is that they have not spoken up loudly enough in this debate to smash the specious arguments from the teabaggers and other Constitution fetishists about how the ACA is "bad".  What's bad is expecting our nation and our economy to continue as things were.

            "The bass player is always right"

            by BigOkie on Sun Jul 22, 2012 at 09:04:24 AM PDT

            [ Parent ]

            •  The health care industry is getting its ducks in a (1+ / 0-)
              Recommended by:
              NWTerriD

              row, including getting organized and lining up funding, for a push on governors and legislatures. Nobody seems to expect any motion on these issues until after November. Yet another reason to GOTV for House and Senate Democrats.

              Hands off my ObamaCare[TM] http://www.healthcare.gov

              by Mokurai on Sun Jul 22, 2012 at 11:43:22 AM PDT

              [ Parent ]

            •  The only people they have to convince (0+ / 0-)

              are members of Congress. They don't have to defend ACA publicly (and thereby lend support to the hated Obama), they just have to ensure that the law stands and the exchanges happen.

              And ater November there will be no downside for members of Congress who vote to uphold ACA, because the major provisions of the law will be in effect before the next midterms, so the law will have a lot more support by then.

              "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

              by NWTerriD on Sun Jul 22, 2012 at 02:22:57 PM PDT

              [ Parent ]

    •  You mean cat-killer Bill Frist? (1+ / 0-)
      Recommended by:
      Mol
      •  Did he do it for fun or was there a reason? (0+ / 0-)

        How big is your personal carbon footprint?

        by ban nock on Sun Jul 22, 2012 at 06:37:01 AM PDT

        [ Parent ]

        •  He used feral cats... (2+ / 0-)
          Recommended by:
          Odysseus, Fury

          ...to practice surgical procedures while in college.

          Rumor is he would bring the strays in, feed them and get them happy and comfortable. Once they were happy, he would kill them and use their dead bodies.

          •  It might seem cold blooded but I believe it's ok (1+ / 1-)
            Recommended by:
            cocinero
            Hidden by:
            LarryNM

            The only solution to ferals is euthanizing, if they can help someone to study medicine all the better. Obviously a healthy disease free animal would be best. I've had cats as pets because I like them a lot. I like the type of personalities they have and I like the way they act, but that doesn't stop me from realizing they are an animal without concept of a finite life. If he treated them humanely and they suffered no pain I'm ok with it.

            How big is your personal carbon footprint?

            by ban nock on Sun Jul 22, 2012 at 08:20:39 AM PDT

            [ Parent ]

            •  trap, neuter, and release (2+ / 0-)
              Recommended by:
              Desert Rose, Bush Bites

              is considered to be a better response. Returning neutered cats to their previous areas seems to help keep the population down in the long run.
              My understanding was he didn't trap the animals, he "adopted" them under false pretenses. But there's a fair amount of mythology around his history on this subject. It is clear he used cats for surgical practice; he has admitted as much.

              Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

              by stitchmd on Sun Jul 22, 2012 at 08:24:00 AM PDT

              [ Parent ]

              •  hey, check this out, stitch (2+ / 0-)
                Recommended by:
                stitchmd, cocinero

                "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                by Greg Dworkin on Sun Jul 22, 2012 at 08:28:46 AM PDT

                [ Parent ]

              •  trap neuter release isn't supported by wildlife (0+ / 0-)

                professionals who have studied it. It just leads to more un neutered cats being dumped and more small species getting eaten and more sick cats.

                The magazines for wildlife professionals cover the whole issue from time to time. TNR is a sore subject for them, they are concerned with species extinction and endangerment.

                How big is your personal carbon footprint?

                by ban nock on Sun Jul 22, 2012 at 11:18:02 AM PDT

                [ Parent ]

                •  I see that (0+ / 0-)

                  and I know that cats (I can't think of the genus/species proper designation) are the major threat to song birds, so I understand where that is coming from. But capturing and destroying them doesn't do it either; if you clear out a nest, others come in to take their place.

                  The best thing is for pet owners to have their kitties neutered early. I personally have always had strictly indoor cats; I've also always had females, not toms, so it is much easier to control their fertility.

                  Thanks for the response.

                  Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

                  by stitchmd on Mon Jul 23, 2012 at 06:26:00 PM PDT

                  [ Parent ]

          •  But it wasn't JUST ferals (1+ / 0-)
            Recommended by:
            Bush Bites

            He would also "adopt" kittens from animal shelters, promising to give them a good home. One of the biggest shelters (possibly more than one) "got wise" to him and refused to allow him any more "adoptions".

            And if you think he wouldn't hunt the want ads for "free kittens"....

            If it's
            Not your body,
            Then it's
            Not your choice
            And it's
            None of your damn business!

            by TheOtherMaven on Sun Jul 22, 2012 at 08:58:12 AM PDT

            [ Parent ]

            •  He's a jerk, no question. (0+ / 0-)

              But he's right in this particular instance.

              "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

              by Bush Bites on Sun Jul 22, 2012 at 09:05:07 AM PDT

              [ Parent ]

              •  As I recall, there are more for-profit hospitals (1+ / 0-)
                Recommended by:
                NWTerriD

                in red states. Giving more money to corporations is a Republican commandment, so Perry, Scott (another medical thief) and others will come around.

                The GOP is the party of mammon. They mock what Jesus taught.

                by freelunch on Sun Jul 22, 2012 at 09:20:56 AM PDT

                [ Parent ]

              •  And if it was *your* kitten he "adopted", (1+ / 0-)
                Recommended by:
                LarryNM

                and you found out later what he'd done to it? Would you still feel the same?

                If it's
                Not your body,
                Then it's
                Not your choice
                And it's
                None of your damn business!

                by TheOtherMaven on Sun Jul 22, 2012 at 10:33:11 AM PDT

                [ Parent ]

                •  OK, how about this. (1+ / 0-)
                  Recommended by:
                  NWTerriD

                  He's an amoral low-life scumbag who isn't worth spitting on, but he is correct when he says Repub governors shouldn't boycott the accountable care act.

                  "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

                  by Bush Bites on Sun Jul 22, 2012 at 12:54:35 PM PDT

                  [ Parent ]

                  •  True that, even if it's greed that motivates him (0+ / 0-)

                    The Affordable Care Act will prop up the health insurance industry a little longer and direct more fees into the hands of the insurance companies - so Frist and his buddies benefit right along with all the rest of us.

                    If it's
                    Not your body,
                    Then it's
                    Not your choice
                    And it's
                    None of your damn business!

                    by TheOtherMaven on Sun Jul 22, 2012 at 06:52:04 PM PDT

                    [ Parent ]

    •  Frist is a far cry from one of those. However (8+ / 0-)

      he's one of those who's not afraid to let the cat out of the bag about the Republican provisions in the ACA.
      Let's all understand one thing:
      It's all kabuki.
      The Republicans are going to take both sides of the debate simultaneously.
      Frist knows why Perry is going to posture against "Obamacare"...because it has Obama's name attached to it.
      Perry knows that most of the provisions are ones that the hospital, drug or insurance industries asked for.
      The gop "repeal" of the ACA is purely for the purpose of taking Obama's name off it, but the only parts of it they really want to shut down are the ones that benefit patients.

      You can't make this stuff up.

      by David54 on Sun Jul 22, 2012 at 06:58:46 AM PDT

      [ Parent ]

    •  I'm not sure Frist is a good example! (2+ / 0-)
      Recommended by:
      IndieGuy, Fury

      It's pretty sad when he looks even remotely sane compared to the current crop of Republicans.

      I remember when the party had a sizable sane contingent.  Sadly  they have either died, retired or been drummed out of the party.  The party is almost unrecognizable as having any principles at all, and is almost totally irresponsible and self-serving these days.

      •  What I find so disturbing is that so many in the (1+ / 0-)
        Recommended by:
        Desert Scientist

        party, whom I previously regarded as sane, are making insane noises.  It's truly as if someone spiked their punch!  When the Supreme Court is parroting Fox "news" talking points, we've got a problem!  It's quite frightening to think that even intelligent legal minds, supposedly determined to be objective, are being poisoned with this extremism.  And so, when I read or hear a sane republican speak, I wonder, "how did he get away?"

        Got Social Security? Thank a Democrat!

        by Fury on Sun Jul 22, 2012 at 08:41:56 AM PDT

        [ Parent ]

    •  It's not that Frist is particularly good... (2+ / 0-)
      Recommended by:
      cocinero, itzik shpitzik

      ...but more that the current batch of Republicans is so much worse.

      He stands out in the Republican party in the same way that a D+ would stand out in a report card full of flunking grades.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Jul 22, 2012 at 08:48:09 AM PDT

      [ Parent ]

  •  The Tea Party Effect (17+ / 0-)

    Have a point of view with nothing to back it up with and then stick to it no matter what.

    This head movie makes my eyes rain.

    by The Lone Apple on Sun Jul 22, 2012 at 06:10:50 AM PDT

  •  'forever' is a long time. (8+ / 0-)
    and it is unclear how long the Republicans will be able to fight reality and stonewall reform.
    For many, it is 'after hell freezes over'. I don't expect any sensible discussion by the rpubs to take this issue on. They are determined to ignore reality at all costs in order to defeat the president and feel like they won the big game.

    OK...what are you going to do to make things better? They have no answers.


    Universe started with a Big Bang. It's big, getting bigger, and mostly dark.

    by jim in IA on Sun Jul 22, 2012 at 06:10:59 AM PDT

    •  Until Nov. 6, 2012 (1+ / 0-)
      Recommended by:
      pamelabrown

      The results of the election will determine the future of Obamacare. If the President is re-elected, the Dems hold the Senate, and a significant number of TEA Party House Republicans are defeated, the ACA will move forward. Republican governors are posturing now, but after the election, they will be more realistic. That includes Terry Branstad who will listen to hospital and insurance company execs.

      •  If the President is re-elected (1+ / 0-)
        Recommended by:
        cocinero

        the Dems hold the Senate, OR we re-take the House, ACA will move forward. It just takes a veto or a majority of "no" votes in either chamber of Congress to prevent repeal of ACA or any part of it.

        The only way ACA goes away is if we lose all three parts of the fed election in 2012. After 2012, it won't matter, because the major portions of ACA will be in effect before the mid-terms, and it will have popular support.

        And because of this, even conservadems in red states or districts can vote with the party on this issue in relative safety.

        "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

        by NWTerriD on Sun Jul 22, 2012 at 02:57:48 PM PDT

        [ Parent ]

  •  Call the Waambulance! Frist might have.... (2+ / 0-)
    Recommended by:
    OleHippieChick, marykk

    to make some sacrifices for the good of others, and that's just shocking!  Of course, Frist and Company have no problem with demanding that ,  "austerity measures" be inflicted on the rest of us,    just as long as he and his rich cronies don't have to give up a damn thing.

  •  Terry Schiavo (20+ / 0-)

    The way this man behaved during the disgusting Schiavo fight made me sick. This is a guy that was a doctor and he sold his soul to the GOP.  

    "He made us all to be just like him" So, if we're dumb, then god is dumb and maybe even a little ugly on the side. Frank Zappa

    by Cairns on Sun Jul 22, 2012 at 06:15:43 AM PDT

  •  Some self-interest (13+ / 0-)

    I imagine he has some HCA stock or dividends, but I think it is amazing how Republicans don't start making sense until they retire.

    •  Hey, I have some (7+ / 0-)

      health care mutual funds, after hearing that because of the ACA, it would become one of the fastest growing sectors in the US. That was 2 years ago, and that fund has grown 25%.
      He could be doing it because as a doctor, he recognizes the need to cover everyone:

      As a doctor, I strongly believe that people without health insurance die sooner. Sure, they can eventually go to an emergency room. But it is often too late. They wait longer to get a breast lump checked out. They wait until their nagging cough turns into a fulminant pneumonia. They skip preventive care and then show up to the ER with severe, costly, late-stage symptoms that are harder and more expensive to treat.

      “We are not a nation that says ‘don’t ask, don’t tell.’ We are a nation that says ‘out of many, we are one.’” -Barack Obama

      by skohayes on Sun Jul 22, 2012 at 06:49:52 AM PDT

      [ Parent ]

      •  Just curious; did your mutual fund see a bump ... (0+ / 0-)

        ... from the Supreme Court decision?

        •  No, it didn't (1+ / 0-)
          Recommended by:
          davehouck

          Though I admit, I don't really look at it every day or even every week, so there could have been a small bump that went unnoticed.

          “We are not a nation that says ‘don’t ask, don’t tell.’ We are a nation that says ‘out of many, we are one.’” -Barack Obama

          by skohayes on Sun Jul 22, 2012 at 07:30:03 AM PDT

          [ Parent ]

          •  Thanks for the reply (1+ / 0-)
            Recommended by:
            skohayes

            I haven't looked at the makeup of such funds, but I'm guessing they have a mix of insurance companies, hospitals, HMOs, drug companies, and medical equipment companies.  So in response to something like the Supreme Court decision, investors in those various industries may have reacted differently, offsetting each other so that the overall fund share price didn't move much.  It will be interesting to see how such funds move as a result of the presidential and congressional elections in November.

      •  Call me jaudiced, but the Republicans had (2+ / 0-)
        Recommended by:
        Fury, skohayes

        control of the house, senate and WH from 2002-2007. what was the result: Medicare Part D which has a huge unfunded gift to big Pharma and the Teri Shiavo case.  Medicare Part D added an additional $1 trillion to the deficit and made it illegal for  Medicare to negotiate for lower prices.
         I remember Frist diagnosing Schiavo on the basis of a tape.   When he had a chance to do something about health care he chose instead to gin up a controversy about a women in a vegetative state for political gain. And now he is worried about his grandkids - it seems to me he had plenty of opportunity when he was Majority Leader to lead on this and didn't stick his neck out.

        So while I am glad he is finally seeing the light, it is too bad it happened when he was retired, and not when he had power in his party.

    •  Are you kidding? Frist walks hand in (2+ / 0-)
      Recommended by:
      Fury, howd

      fucking hand with the health insurance industry.  For these parasites the ACA is like an infinite supply of blood for them suck on.

      "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

      by Subterranean on Sun Jul 22, 2012 at 08:19:24 AM PDT

      [ Parent ]

  •  To give $$ perspective .... this is from 2008 (9+ / 0-)
    Lehman Brothers Analyst Adam Feinstein said in a note to investors that one of the biggest positive items in HCA’s second quarter was its ability to stabilize bad debt expense.  HCA said it set aside $813 million, or 11.7 percent of revenues, in the second quarter for doubtful accounts.  During the year ago period, HCA set aside $753 million, or 11.2 percent of revenues. Charity care and uninsured discounts climbed almost 23 percent during the quarter to $869 million, compared with $707 million a year ago.

    Overall, Feinstein said HCA’s total uncompensated care expense — which includes bad debt expense, charity care and discounts — was flat at 21.4 percent.

    Reference

    That percentage of bad debt, charity care and discounts is greater than what I saw for some recent net profit margins so you can only imagine how HCA and other large hospital systems will fare under the ACA.  And community not for profits with disproportionate share of uninsured will do even better.

  •  Not Forever (5+ / 0-)
    Recommended by:
    marykk, skillet, Egalitare, chuco35, cocinero

    just till november. the GOP governors are hoping for a Romney win that will save them from Obamacare.    

    First they ignore you, then they laugh at you, then they fight you, then you win. Mohandas Gandhi

    by texasteamster on Sun Jul 22, 2012 at 06:26:23 AM PDT

    •  If Romney wins and the Repubs take both houses (7+ / 0-)

      of Congress, that will happen.  Don't count on the 60 vote rule, that will last one day in a Republican controlled Senate, especially if they get the trifecta.

      "We have always known that heedless self-interest was bad morals, now we know that it is bad economics." Franklin Delano Roosevelt, Jan. 20, 1937

      by Navy Vet Terp on Sun Jul 22, 2012 at 06:57:02 AM PDT

      [ Parent ]

      •  60 votes won't be needed; simple majority will do (2+ / 0-)
        Recommended by:
        cocinero, NWTerriD

        The ACA was passed in the Senate through reconciliation and was not subject to filibuster. In the above scenario, it would be repealed through reconciliation, especially since the mandate has now been firmly deemed to be a tax.

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

        by stitchmd on Sun Jul 22, 2012 at 08:52:48 AM PDT

        [ Parent ]

  •  Frist's family one of founders of Chattanooga? (3+ / 0-)
    Recommended by:
    marykk, DemFromCT, skohayes

    News to me.  I live in the Chattanooga area and love local history and genealogy.  Frist family is well established in the Nashville area.  

    Will do a little research on this.  

  •  Stick to your guns RedState Govenators....there's (6+ / 0-)

    a 'Principle' involved somewhere in your reticence....When you find it, let your constituents know.

    •  In the meantime.... (2+ / 0-)
      Recommended by:
      howd, cocinero

      ....federal aid shifts to the blue states, who pay most of the bills anyway.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:28:08 AM PDT

      [ Parent ]

      •  At least some of the red states will be better (1+ / 0-)
        Recommended by:
        Bush Bites

        off under the federally operated exchange that will be imposed on them than under anything they would design themselves.

        Eliminate tax breaks that stimulate the offshoring of jobs.

        by RJDixon74135 on Sun Jul 22, 2012 at 08:49:04 AM PDT

        [ Parent ]

        •  All of them will, I would bet. (0+ / 0-)

          Healthcare is horrible in the red states.

          "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

          by Bush Bites on Sun Jul 22, 2012 at 08:51:18 AM PDT

          [ Parent ]

        •  But if they pass on the Medicaid expansion... (1+ / 0-)
          Recommended by:
          auditor

          ...which many say they will....that money goes to the blue states.

          "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

          by Bush Bites on Sun Jul 22, 2012 at 08:52:18 AM PDT

          [ Parent ]

      •  It also means that the poor... (3+ / 0-)
        Recommended by:
        DemFromCT, stitchmd, auditor

        ...who lack health insurance and live in states with Republican governors end up getting screwed.

        And remember, living in a red state doesn't mean that everyone who gets hurt actually voted for these jackasess.

        That "more for me" attitude is not very progressive.

        Political Compass: -6.75, -3.08

        by TexasTom on Sun Jul 22, 2012 at 08:51:24 AM PDT

        [ Parent ]

        •  eh, think of it not as an endorsement (0+ / 0-)

          but as a reason for red states to reconsider.

          the Missouri guy I quoted in the original post puts it that way.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 22, 2012 at 08:52:50 AM PDT

          [ Parent ]

  •  I got so lost reading one of the links I forgot (8+ / 0-)

    where I'd come to the link from.

    Good post, good to keep one's eye on the ball. Health care is I guess my biggest most immediate issue. The world might end from global warming but I want my kids and I to be around to see it.

    How big is your personal carbon footprint?

    by ban nock on Sun Jul 22, 2012 at 06:36:24 AM PDT

    •  bless you (7+ / 0-)

      for clicking and reading links.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 22, 2012 at 06:39:36 AM PDT

      [ Parent ]

      •  I might miss some (3+ / 0-)
        Recommended by:
        Amber6541, davehouck, Odysseus

        in your APR diaries, but when you blog about a Republican  who embraces state health care exchanges (not a huge stretch, as Frist points out), it's worth reading why!
        Though I didn't like this:

        Want a more conservative, small-business focused exchange that bans abortion coverage in all its plans? Try Utah and its state exchange, originally founded under Gov. Jon Huntsman.
        Yikes, I hope Republicans don't see that!

        “We are not a nation that says ‘don’t ask, don’t tell.’ We are a nation that says ‘out of many, we are one.’” -Barack Obama

        by skohayes on Sun Jul 22, 2012 at 06:53:59 AM PDT

        [ Parent ]

        •  Yes, one of the interesting things that ... (4+ / 0-)
          Recommended by:
          skohayes, Fury, ban nock, LarryNM

          ... came to mind as I was reading Frist's article is that the significantly varied look of the exchanges, as suggested by Frist, could induce quite a large number of people to migrate from one state to another.  For instance, as I was reading the article I was reminded that I need to look into moving to Vermont.

  •  Frist links to (11+ / 0-)

    an article you really ought to read:  4 reasons Rick Perry may regret battling ObamaCare.

    I am so pleased to see Republicans making this an issue!

    For those that don't feel like reading this morning, I will provide the 4 summary reasons here:

    1)  Perry and other GOP governors are losing out on a windfall
    2)  Perry is giving the federal government more control in Texas
    3)  Hospitals and states will have to pay ER bills for the poor
    4)  Republicans will own the broken health-care system

    This is simply delicious!  

    Full disclosure:  I live in Texas, am very concerned about this, and I despise Perry.

    •  It's so great to wake up in the morning to (2+ / 0-)
      Recommended by:
      Fury, indie17

      smell the blood of your enemies as they fight across the street.

      "Force is as pitiless to the man who possesses it, or thinks he does, as it is to its victims; the second it crushes, the first it intoxicates.” Simone Weil

      by chuco35 on Sun Jul 22, 2012 at 07:42:20 AM PDT

      [ Parent ]

    •  Perry doesn't care about number 3 (1+ / 0-)
      Recommended by:
      indie17

      ...because the cost of indigent health care in Texas goes to the counties, not to the states.  And he frankly doesn't care if he throws county finances in the ditch, because he won't be held responsible for problems at the county level.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Jul 22, 2012 at 08:52:56 AM PDT

      [ Parent ]

    •  The article overlooks one important thing. (1+ / 0-)
      Recommended by:
      indie17

      Rick Perry is DUMB.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:58:23 AM PDT

      [ Parent ]

  •  Thank you for this diary. I have been better (6+ / 0-)

    informed due to the diaries on this site about the negotiations between hospital associations willing to provide lower rates to the exchanges, medicare and medicaid knowing there was the likelihood that people entering their hospitals would be covered.  Makes sense.

    Also am residing in a state that swears they won't set up an exchange.  Reading that federal systems will kick in and set one up for us was so reassuring.  Maybe we'll have a better system in that case than if it were left to the GOP here.

  •  Just read the Frist article (7+ / 0-)

    This is from the article (my bolding) ...

    "... I strongly believe that people without health insurance die sooner. Sure, they can eventually go to an emergency room. But it is often too late. They wait longer to get a breast lump checked out. They wait until their nagging cough turns into a fulminant pneumonia. They skip preventive care and then show up to the ER with severe, costly, late-stage symptoms that are harder and more expensive to treat."
    The article is short and worth the read.  It would have been helpful if he had contributed his voice on this a good bit sooner.  I hope his fellow Republicans can quell the selfish political tantrums long enough to listen to him and actually think rationally for a minute or two.
  •  As long as the AHCA is the law, Texas will have (2+ / 0-)
    Recommended by:
    OhioNatureMom, auditor

    an exchange. Either they can run their own and take federal funding for it, or they don't.

    And then the federal government will allow Texans to buy into a broader exchange and the state will have no say on what the lowest health care rate will be for their state.

    Maybe this is why Frist is trying to restrain the exchanges on a state by state level.  The smallest pools are the most vulnerable and will pay the most.

    The Muslim said "I wished I had met Christ before I met the Christians" - Rev. Marvin Winins

    by captainlaser on Sun Jul 22, 2012 at 07:11:53 AM PDT

  •  He's also a member of AMA and AHA.... (3+ / 0-)
    Recommended by:
    OhioNatureMom, davehouck, jj32

    .....both of which supported HCR.

    And he supported HCR when it was stuck in congress.

    So, I wouldn't say it's ALL self interest.

    "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

    by Bush Bites on Sun Jul 22, 2012 at 07:15:48 AM PDT

    •  well, you might say (2+ / 0-)
      Recommended by:
      marykk, pamelabrown

      he recognized his self-interest early, but my point is that he'll be a voice for moderation, whatever his motives.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 22, 2012 at 08:01:18 AM PDT

      [ Parent ]

      •  Yeah, hopefully. (1+ / 0-)
        Recommended by:
        marykk

        Man......the IQ of the Repub Senate Leader dropped precipitously when it went from Frist to McConnell.

        "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

        by Bush Bites on Sun Jul 22, 2012 at 08:24:39 AM PDT

        [ Parent ]

  •  We Need to Push This (0+ / 0-)

    We need to strongly push the fact that "Obamacare" was based on "Romneycare". In addition to the benefits of the Health Care Act we have to keep hammering away at the hypocrisy of the Republicans and Romney condemning something they supported in the past. We aren't pushing this hard enough.

    "A dreamer is one who can only find his way by moonlight, and his punishment is that he sees the dawn before the rest of the world." Oscar Wilde

    by michelewln on Sun Jul 22, 2012 at 07:21:23 AM PDT

  •  --Assuming There's Any Such Thing as a "State" (2+ / 0-)
    Recommended by:
    deha, skillet

    when it comes to motivating Republican governance.

    The question of whether a policy benefits the nation, a state or the people is just about the last question any conservative in government is going to come to before reaching a decision.

    The only important question is what benefits global ownership, and I don't see state exchanges as having benefits global ownership will support as much as they'll support stonewalling and bringing down all of reform.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Sun Jul 22, 2012 at 07:25:50 AM PDT

  •  It's amazing how a one-time GOP idiot like Frist (4+ / 0-)

    can today sound almost sensible. It's a stark indication of how thoroughly the GOP has been captured by raving wingnut ignoramuses.

  •  If you don't do it yourself... (2+ / 0-)
    Recommended by:
    joynow, maybeeso in michigan

    This reminds me of my son, at age 3.  I would patiently explain to him that he could get in the car, or he could be put in the car.  Either way, he's getting in the car.

    It took him until about 5 to figure out that Daddy always wins.

    We've told the states that if they don't do it themselves, we'll do it for them.  And a small number of R governors are planning to dig in their heels and be placed in the default Federal exchange.

    Like my son, this is a win-win.  The state gets all the benefits of Obamacare, while the governor gets all the benefits of acting like a tea-partying ass.  The nation as a whole wins, too, when our spending on health care comes under control and people nationwide are healthier.

    Early to rise and early to bed Makes a man healthy, wealthy, and dead. --Not Benjamin Franklin

    by Boundegar on Sun Jul 22, 2012 at 07:35:58 AM PDT

  •  Question (1+ / 0-)
    Recommended by:
    Bush Bites

    Can the federal government now set up a FEDERAL health care exchange that people can get into when states don't set them up?  That's probably been asked and answered a number of times here and I just missed it.

    Thanks, anyone.

    The truth is sometimes very inconvenient.

    by commonsensically on Sun Jul 22, 2012 at 07:41:48 AM PDT

    •  That's in the ACA. (2+ / 0-)
      Recommended by:
      commonsensically, LarryNM

      Siebelius will build an exchange for states that don't build their own.

      (though, it won't be a "federal" exchange, it will be pretty similar from state to state.)

      Which is why Frist is saying Repub governors should do their own rather than have a "one size fits all" exchange foisted on them.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:00:29 AM PDT

      [ Parent ]

      •  According to a friend who works at HHS (4+ / 0-)
        Recommended by:
        Bush Bites, jj32, pamelabrown, wsexson

        (high in admin) this is a VERY big deal right now; they are working very hard with the states who are working on the exchanges, but also trying to scramble to see who is and who is not going to comply. It's a monstrous job with ever shifting targets.

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

        by stitchmd on Sun Jul 22, 2012 at 08:34:25 AM PDT

        [ Parent ]

        •  Yeah, I can imagine. (0+ / 0-)

          I don't envy HHS.

          It'd be hard enough putting this thing together if you didn't have a bunch of teabagger governors fighting you every step of the way.

          "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

          by Bush Bites on Sun Jul 22, 2012 at 08:38:21 AM PDT

          [ Parent ]

    •  yes, that's the deal n/t (1+ / 0-)
      Recommended by:
      commonsensically

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 22, 2012 at 08:02:12 AM PDT

      [ Parent ]

  •  I don't understand why the exchanges take so long. (1+ / 0-)
    Recommended by:
    jj32

    It's basically a web software package with a bunch of agree-to insurance policies, isn't it?

    "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

    by Bush Bites on Sun Jul 22, 2012 at 07:57:50 AM PDT

    •  some of the issues (1+ / 0-)
      Recommended by:
      stitchmd

      this short discussion gives you a flavor of why:

      State Implementation Decisions:

      It is unclear at this point if states can or will include their individual state benefit mandates in the essential benefit packages described earlier. Will Minnesota health plans in the Exchange be required to provide coverage of wigs for cancer patients as they are for small groups now? Will Louisiana continue in the Health Insurance Exchanges to be the only state to mandate coverage for attention deficit disorder?

      These are important decisions as states grapple with building their Exchanges. Advocates fought hard to gain these benefit mandate provisions and one can only assume they will be actively lobbying legislatures to include them again.

      Of course states can also decide to opt out of implementing its own Exchange and give up control by letting the federal government do it. Obviously some states will allow the federal government in, but others like Wisconsin may not want to give up control.

      Then there are decisions like implementing Exchanges regionally or across an entire state, opening them up to employer groups as large as 200 employees in 2017, and others.

      This is a huge effort and it will be very interesting to see what nuances states develop. Hopefully, they will be largely similar and easily navigated by consumers, agents, and others.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 22, 2012 at 08:05:53 AM PDT

      [ Parent ]

      •  Interesting. (0+ / 0-)

        Too bad they can't have a template for a very basic package -- catastrophic, yearly checkups, etc. -- then flesh it out further as time goes on.

        "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

        by Bush Bites on Sun Jul 22, 2012 at 08:13:28 AM PDT

        [ Parent ]

        •  think of it as all states agreeing (1+ / 0-)
          Recommended by:
          jj32

          on medicaid coverage standards, or school curriculum.

          On paper, great. But, in practice...

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 22, 2012 at 08:24:00 AM PDT

          [ Parent ]

        •  however, what you refer to is (1+ / 0-)
          Recommended by:
          Bush Bites

          likely what the federal exchange implementation (for those states who don't do it themselves) will look like.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 22, 2012 at 08:25:06 AM PDT

          [ Parent ]

          •  good point (2+ / 0-)
            Recommended by:
            Bush Bites, DemFromCT

            I would expect that the federal exchanges would be based on the minimal recommendations of the USPSTF and CMS guidelines. People might be surprised at how very limited those guidelines are, compared to what they get now under many private healthcare plans and state mandates.

            Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

            by stitchmd on Sun Jul 22, 2012 at 08:38:14 AM PDT

            [ Parent ]

  •  Frist must LOVE ACA (1+ / 0-)
    Recommended by:
    howd

    After all, it's a federal guarantee of corporate windfall profits for him and his ilk.

    If this guy likes it, that's a signal that we all need to stop and reflect upon our support for this corporate welfare queen act.

    "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

    by Subterranean on Sun Jul 22, 2012 at 08:17:01 AM PDT

    •  actually, a ridiculous comment (2+ / 0-)
      Recommended by:
      Bush Bites, TexasTom

      at every level.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 22, 2012 at 08:19:31 AM PDT

      [ Parent ]

      •  I am no fan of Frist's (1+ / 0-)
        Recommended by:
        marykk

        but if he has his own reasons for supporting it (some for significant self interest)  that does not automatically make it bad.

        He breathes oxygen and eats food. Does that make both evil?

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 22, 2012 at 08:27:14 AM PDT

        [ Parent ]

      •  Noted that you cannot respond to it (0+ / 0-)

        with any sort of substance.

        Here's a thought excercise for you:  imagine the ACA never passed, and that Romney wins the presidential election.  His first act as president is to introduce the ACA.  

        How does dKos respond?  Do we all cheerfully support Romney's new ACA?  No?  Or, no shit?

        "When I was an alien, cultures weren't opinions" ~ Kurt Cobain, Territorial Pissings

        by Subterranean on Sun Jul 22, 2012 at 09:26:35 AM PDT

        [ Parent ]

      •  Ridiculous? (1+ / 0-)
        Recommended by:
        Owlet

        At every level?  So what is so ridiculous?  The part where ACA will guarantee corporate profits?  The title to your own diary, "Bill Frist tell GOP Governors You are Taking Silver Spoons Out of My Grandchildren's Mouths"?, would seem to indicate that you believe that the ACA would guarantee profits for his family's insurance business.

        And I don't know about you but anytime a Republican supports something I always make sure to give it a second and third look.  And every time I have looked, it usually shows a program that helps, first and foremost, the rich and powerful, or helps the Republican politician personally.

        Finally, for all the good things ACA will do, it is still a deeply flawed program. It keeps in place unnecessary private insurance companies that suck out profits and excessive executive salaries that could be going to treat sick people.  The ACA will only strengthen the private insurance companies and make it that much more difficult to get to single payer, which is the most efficient and humane plan.  

        Poor man wants to be rich. Rich man wants to king. And the king ain't satisifed until he rules everything. B.Springsteen

        by howd on Sun Jul 22, 2012 at 09:32:26 AM PDT

        [ Parent ]

        •  at every level (0+ / 0-)

          To be against something because x is for it? As it happens Bachmann and DeMint are against it. Good example of why that brainless technique fails. One needn't be a Frist supporter, or even totally enamored of ACA (it's the best of possible things that could pass, not best idea evah) to get that.

          As it also happens, ACA is not getting relitigated.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 22, 2012 at 11:59:15 AM PDT

          [ Parent ]

  •  hmmm. (2+ / 0-)
    Recommended by:
    Sandy on Signal, howd
    People like their medicare, private insurance not so much http://t.co/...
    @DemFromCT via TweetDeck

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Sun Jul 22, 2012 at 08:19:59 AM PDT

  •  from the great state of Tennessee (2+ / 0-)
    Recommended by:
    Bush Bites, marykk
    The head of the Tennessee Hospital Association says hospitals in the state are going to suffer if TennCare is not expanded under the new federal health care law.

    While the U.S. Supreme Court recently upheld most of the Affordable Care Act, justices struck down a mandate for states to expand their Medicaid programs. The court gave states the choice of opting into the Medicaid expansion in 2014.

    “We’re going to have to sit down with the administration to see what we can do about it,” Craig Becker, president of the Tennessee Hospital Association, told the Chattanooga Times Free Press. “It’s pretty clear that that is absolutely our Achilles heel right now.”

    http://www.jacksonsun.com/...

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Sun Jul 22, 2012 at 08:38:43 AM PDT

    •  He has a big job ahead of him. n/t (0+ / 0-)

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:43:15 AM PDT

      [ Parent ]

    •  Tennessee has a history here, though (3+ / 0-)
      Recommended by:
      Bush Bites, DemFromCT, marykk

      remember, a number of years ago they tried to significantly expand TennCare, just to cover basic coverage. And it cost dramatically more than what they expected. I'm sure that history will not be forgotten as they consider this type of expansion.

      One of the problems, of course, is defining what "basic" coverage is. I know I've mentioned my (brief, frustrating) time working in an FQHC several times before, but it provided a first hand look at the significant limitations of providing "basic" care.

      In Maryland, the gov (O'Mally 2016!) is preparing by markedly decreasing the reimbursement to providers, even before the expansion goes into effect. But no doubt Maryland will participate, of course.

      Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

      by stitchmd on Sun Jul 22, 2012 at 08:45:32 AM PDT

      [ Parent ]

  •  OK Gov. Mary Fallin (0+ / 0-)

    is sure to get such a letter from Frist, since the Frist family's HCA owns a major hospital in Oklahoma City. It used to be the public hospital for central OK, until the state legislature approved selling it to the Frists for a song, over grassroots protest.

    Oklahoma: birthplace of Kate Barnard, W. Rogers, W. Guthrie, Bill Moyers & Eliz. Warren. Home to proud progressive agitators since before statehood. Current political climate a mere passing dust cloud; we're waiting it out & planning for clearer days.

    by peacearena on Sun Jul 22, 2012 at 08:39:13 AM PDT

    •  Bet it was failing. (1+ / 0-)
      Recommended by:
      stitchmd

      And they sold it to get the losses off their books.

      Public hospitals are sinkholes of debt -- they get the people least able to pay who are usually in the worst medical condition.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:46:21 AM PDT

      [ Parent ]

      •  Happening all the time (1+ / 0-)
        Recommended by:
        Bush Bites

        including hospital owned clinics, which have become major loss leaders for many. More than a few clinics have turned the management of these clinics over to corporations who run them as FQHCs. I would love to see the books for many of those companies.

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

        by stitchmd on Sun Jul 22, 2012 at 08:57:32 AM PDT

        [ Parent ]

        •  I wonder if that will change? (0+ / 0-)

          Aren't hospitals trying to collect more clinics as part of transitioning to Accountable Care Organizations?

          Or do I have the definition of ACOs all wrong?

          "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

          by Bush Bites on Sun Jul 22, 2012 at 09:03:29 AM PDT

          [ Parent ]

          •  They are trying to get more primary care (0+ / 0-)

            providers, but that doesn't mean they want to pick up the charity clinics necessarily. It will be interesting to see what the role of the charity clinics will be as more people get insured; however, outpatient reimbursement to private docs for Medicaid are still so low that there will undoubtedly be a role for them.

            And there are not enough primary care providers to go around.

            Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

            by stitchmd on Sun Jul 22, 2012 at 09:31:07 AM PDT

            [ Parent ]

    •  Most public hospitals also need a lot of tech... (0+ / 0-)

      ....investments to get up to speed on electronic medical records, which are very expensive.

      I'm sure it was down to begging somebody to take it off their hands, or shutting it down.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 08:54:51 AM PDT

      [ Parent ]

  •  Difference between Romneycare & Obamacare (0+ / 0-)

    ...is simple.

    Obamacare doesn't cover abortion.

    America, we can do better than this...

    by Randomfactor on Sun Jul 22, 2012 at 08:45:33 AM PDT

  •  On ACA - - unleash Michele (1+ / 0-)
    Recommended by:
    Bush Bites

     The Righties are putting together a big anti-Obamacare push for the rest of the campaign.  But we have a not so secret weapon.

      If Michele Obama started coming out big time talking about ACA in a very positive way, it would do 2 very important things..

    1. Educate people about what ACA really is and what it will do for all of us.

    2.  Counter the BS that is spread and will be spread even thicker.

      She can be totally positive, never mentioning Rmoney or the rethugs.  People, especially women, will listen.

    "We borrow this Earth from our Grandchildren."

    by Arizona Mike on Sun Jul 22, 2012 at 08:56:53 AM PDT

    •  She used to work for U of C hospitals, I believe. (0+ / 0-)

      Surprised she hasn't talked about this sooner, though she probably didn't want to get "Hillaried" on health care reform.

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 09:08:42 AM PDT

      [ Parent ]

    •  More. (0+ / 0-)
      In 2002, she began working for the University of Chicago Hospitals, first as executive director for community affairs and, beginning May 2005, as Vice President for Community and External Affairs.[49] She continued to hold the University of Chicago Hospitals position during the primary campaign, but cut back to part time in order to spend time with her daughters as well as work for her husband's election;[50] she subsequently took a leave of absence from her job.[51]

      "The disturbing footage depicts piglets being drop kicked and swung by their hind legs. Sows are seen being kicked and shoved as they resist leaving their piglets."

      by Bush Bites on Sun Jul 22, 2012 at 09:11:37 AM PDT

      [ Parent ]

  •  Is this the same Bill Frist (1+ / 0-)
    Recommended by:
    LarryNM

    Who was able to diagnose Terry Schiavo without ever examining her?  I somehow doubt his motives here are entirely altruistic.

  •  Obsessive hatred of Obama... (0+ / 0-)

    has blinded these idiots to how conservatively pro-business the PPACA really is.
    http://content.cartoonbox.slate.com/...

    I suppose it could also be obsessive hatred of the poor (a.k.a. “the other”), but that would be pessimistic.

  •  We already have single payer: the IRS. (1+ / 0-)
    Recommended by:
    Owlet

    At least as far as I can tell.

    When a medical provider writes off a loss b/c the patient is unable to pay, that provider's gross income is reduced, which means they'll be paying less in taxes. IRS loses revenue.

    When you get an HSA or FSA (tax free) the IRS takes a hit.

    When you have your insurance paid for in pre-tax dollars, it's the IRS's loss.

    Our system will evolve from a sloppy single payer system to a real one, in due time.

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