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Episode Three: Healthcare Reform

April 3, 2017

In this episode of News World Order, Kevin and Tony discuss the state of the healthcare industry in the United States. They first cover how healthcare has changed over the course of US history. Then discuss why we needed healthcare reform in 2010 in the form of Obamacare. They tackle the differences between Obamacare and Trumpcare and why Trumpcare failed to pass the House. This is a very informative episode and has a lot of information to take in, so sit back and prepare to learn everything you need to know about Healthcare in the United States.

Show Transcript to follow:

(Tony) Good morning Good afternoon or Good night, Welcome to the Tertiary, the Trinity, the Trilogy or the Third episode of News World Order.  I am Tony Alvarez and I'm accompanied by my co host as always Kevin Alvarez.


(Kevin) Hey everybody, how's it going.


(T) Where we sift through the white noise of mainstream media and give our listeners an analytical, unbiased approach to the stories topping the 24-hour news cycle. Today we're here to discuss health care, which has now been viewed as Trump's first legislative fail. Kevin you want to handle the agenda run down?


(K) Sure, so first what we are going to do is kind of give a rundown of how the healthcare system works in our country. Just kind of a brief, broad overview of how that whole thing works. After that we’ll take a look at the historical process of how Healthcare became part of this country. All of the aids to Health Care,  Medicare, Medicaid and then eventually all the way up into Obamacare. Then we’ll shoot through a comparison about the two. So about what Obamacare really is and what Trumpcare really is and how they are very similar in some regards and how they're very different in some regards. Then we’ll push into a talk about the Congressional opposition to both Obamacare and Trumpcare and where that has left us today. And then after that we'll try, I don't know how well we’ll do but we’ll try and give a way ahead for everybody listening and what that means for our health care in the future. Because it's kind of up in the air at this point as we are recording this episode.


Thats kind of an idea of where we're going to head with this episode. Hopefully it's not too drawn out. The one thing I do want to get out to everybody that does listen to this show. While we kind of try and shift through all the noise and give you guys a good unbiased opinion of these pointed issues that we see in our news media. One thing that I really want to stress on everybody here is, don’t take talking heads as your Bible. The one thing I've learned in doing this podcast was, going out and searching for the information and finding it out for yourself is pretty eye opening and you start to see how things kind of run in our own country and our own government. I think both me and Tony kind of agree here is get out there, don't take our word for it necessarily, don't take Fox’s word for it,  don't take msnbc's word for it. Get out there search for that information yourself and educate yourself on what's going on. We're here to help you but get out there and do it yourself. Just a PSA for everybody listening, I guess.  


(T) Yeah, very good Kev. So let's jump right into it then. So explaining our US Healthcare System in 5 minutes or less it's going to be a tough task but I think we're up for it. We’ve got, in this country basically a mixture of private and public sector providers for healthcare. Most of us are on the beneficiary end of receiving the care provided by the private sector. Your employer is likely the individual or Corporation providing that for you. So about 15% of Americans though are uninsured, which means you basically have to come out of pocket for coverage on any incurred medical costs. Which in America is pretty costly. So with 6 out of 10 Americans unable to cover 500 to $1,000 in unplanned expenses, you can see that there's a lot of people that could probably fall into this category. Pretty devastating effects if you suffered a catastrophic medical injury. In simplest terms though you know the American health-care system is private insurance for most, Medicare and Medicaid for some and Veterans Administration or Tricare for a very few select individuals. Those are the three kind of main buckets in which Healthcare is provided to US citizens. So on the private side you have about 60% of the people who get their insurance from their employer, just like I said. The employer usually doesn't charge different amounts based on discriminators such as age, gender, previous medical history. But it covers things like preventive care, hospital visits, prescription drugs. For those not covered under your employer, which is about 15% of Americans, they’re covered under Medicare. Medicare is essentially a government program, it is most likely for elderly people. It's run by the federal government and you have a series of different programs: Part A is basically covering you if you get hospitalized, Part B covers outpatient services, Part C covers Medicare Advantage or offers a Medicare Advantage where there's an opportunity for private companies to step in and provide Medicare like benefits and if they do that at a lower cost they can reap the benefits and then Part D covers prescription drug plans. Well Kev that covers private and Medicare what about the other two facets?


(K) The other facet that's in the public sector is Medicaid. Generally speaking Medicaid is for our low-income individuals in our country. It's a state run program meaning they have to comply with federal guidelines. Basically it is the closest thing that our country has to universal healthcare program or a single-payer program. So thats kind of how Medicaid works. Lastly, is a section we don't really want to talk or not that  we don't want to talk about it but it's not really relevant to the topic at hand, is our veterans care and that's through Tricare primarily. But that's kind of it's own little entity isn't really affected by Obamacare or Trumpcare so we're just going to kind of leave that aside. You guys can go do your research on that. That kind of covers how the healthcare system works here in our country. Let's shoot for a historical look at how we got to Obamacare being passed in 2010.


(T) So on the historical summary man we’ve got Teddy Roosevelt all the way back in 1912 that really set the foundation for a national health insurance system. That notion really didn't gain traction until Harry Truman pushed for it in 1945 but his bill died in Congress much like we saw with Trumpcare. Part of it was because it was too invasive meaning that the plan envisioned coverage that paid for doctor's visits, hospital visits, laboratory services, Dental Care & Nursing services


(K) Say it ain't so!


(T) So very similar to what's going on, right? It would be another 20 years before Medicare  actually would be implemented, and again like we said before Medicare is coverage for Americans 65 and older. That was after a failed attempt by JFK and then LBJ pick up the torch and got it passed in 1965. I thought was pretty cool as a show of good measure Former President Harry Truman was brought back to receive the first Medicare card at an approval ceremony, so that is pretty neat. Since then we’ve kind of witnessed an expansion in the program, it's kind of the leading theme over the years. Nixon expanded a little bit, to a certain degree, in the 70’s in the 80’s you have a significant expansion for low-income beneficiaries and their families. In that decade you saw soaring medical costs as a result of it. In the 90’s you have the emergence of HMOs and prescription drug benefits started come on board. Then in the 2000s you have that kind of transition to where it was moving away from the older population and getting more younger aged Americans into the program and really that expansion of prescription drug benefits as well. So you really didn’t see that notable change in over a century until 2010 when the Affordable Care Act was signed into law.


(K) So that's a historical view of how we got to the early 2000s and the real question then becomes is with all these changes within our own Health Care System how was it that in 2010 we ended up in a position where we needed significant Health Care reform. So the idea here was the Democrats wanted to enact this reform for health care. The reasoning behind their wanting to reform Healthcare was this notion that health care cost were getting out of control in our country, that too many people were left uninsured. Those were kind of the two basic driving points for the passing of Obamacare. So what I did was I kind of went into what the state of the country was during this time and what they were looking at as opposed to what different organizations were looking at as well.  So a number that likes to get tossed out by proponents for the Affordable Care Act is that our country spends a significant amount more than other countries on our Health Care. And the number that gets thrown around a lot of is that we spend 17% of our country's GDP on Healthcare and just throw a number out there that number is about 2.7 trillion dollars a year on Health Care is what we spend on it in this country. So you can look at that number and say sure that's pretty substantial. But the funny thing is is about that number, that 17 percent number, that estimate includes: Public Health activities, government Administration for the healthcare system, net cost of health insurance that everybody pays into the system, investments related to health care, it includes bringing drugs to market and includes research and development for a medical technology. This number while it seems extremely large it includes a vast amount of information. So you start getting into that and you realize okay we’re spending 17 percent of our GDP but bringing drugs to market and research and development is part of that number. Well just to give you an idea the US produces more than half of the $175 billion dollar industry in the healthcare technology products that are brought to market every year. So that 17 percent of our GDP that two-point,  what I say, 2.7 2.8 trillion dollars say 85 billion dollars of that number is Justin Healthcare technology and new drugs coming to the market. So that's pretty substantial.


(T) Yeah I think it's just hard to get past the fact that the U.S. government spends about $4,100 per person in 2013 in healthcare when you have a similar nation like the UK which you know spends about $2,800 per person.


(K) Sure. Go Ahead.


(T) No that was the point.


(K) Yeah and so I mean that's a very valid point, but the other thing that you have to kind of look at is in a 2008 report from the Congressional budget office it showed that new technologies accounted for the bulk of our increasing health care cost in this country, even more so than an aging American population. While we look at a similar developed country as in the UK we’re saying that we’re spending twice as much per person on healthcare here in the states, I would venture to say that maybe our health care here in the states is significantly better.  I’ve seen some studies and some papers that would show that for instance a man who's diagnosed with testicular cancer here in the states has about a 9, if it's caught relatively early and it's caught in the same time frame, that a man who has testicular cancer in the states the success rate of him being cured of that cancer is in the 90 percentile where as over in the UK is significantly lower its in the 70-80 percentile.  


(T) Sure, yeah but again we got to take a look you know that's an isolated medical condition.


(K) Sure, absolutely


(T) You have these life expectancy projections from various different organizations, one of them being the Commonwealth fund, the average life expectancy under our healthcare system is about 78.8 years and in contrast in Switzerland you have life expectancy of 82.9 years and you know there's a difference in per capita spending between the two Nations.


(K) Well the other thing too on that argument and this is something else that I found. I saw that same study right that are average life expectancy is 71, but you also have to include in that is that a homicide rate is significantly higher than other countries. Our deaths in motor vehicle accidents is significantly higher the states it is and those countries. So numbers, homicide rate and things like that aren’t taken out of life expectancy it's just part of that number. So that number is driven by certain factors that may not necessarily show the


(T) No, absolutely it's a classic case of confirmation bias where you know the end result in which you're trying to arrive and so you're going to find the data that support your conclusion.


(K) Absolutely. So what I found pretty interesting was in the decade and a half prior to the passing of Obamacare in 2010 our Healthcare spending in relation to our GDP hovered around 13% for about a decade and a half. Since the passing of Obamacare we’re sitting at that 17 percent number. Which is understandable right because there's more people in the market now there's more people who have insurance that number that gets to the 17 percent includes our net cost of health insurance. So we would expect that number to go up. That number gets thrown out there and when you start diving and kind of breaking down what that number actually means, to me anyways and this is again like in our prior episode where we said be careful because we're going on our personal opinion. But in my personal opinion that 17 percent number that everybody's throwing out doesn't hold as much weight when you start looking at what that number includes and how that whole system works.


(T) Right and you prefaced it. It’s your personal opinion, but you also prefaced it earlier in the segment and saying we encourage all our listeners to go out and conduct their independent research to verify. You know trust but verify.


(K) So that was just one thing that I found. Here’s another interesting one. So in 2012 the per capita health spending had risen to almost $9,000 which is significant compared to $134 and 1958 and if we adjusted that for inflation it's about a thousand dollars. So between 1958 and 2012 our per capita health spending increased by almost $8,000.


(T) Wow!


(K) So that's pretty significant., well let's take a look at what all that means. Between the years of 2000 and 2010 right that's that was a decade prior to the launching of Obamacare our health-care spending grew at about a 6% rate over the entire decade. The highest being in 2001 which was about 8.5% and the lowest in 2010 which was like 2.5%. As a comparison the same Health Care spending grew by 10.3% in the year 1970 and it grew by 13% in 1980. So in the 2000’s we were about half of what, our healthcare cost were going at about half the right that it was 20 years prior to that. So I found that very interesting, so while we are spending more money it's not growing at an exponential rate that everybody kind of made everybody think that it was going at.


(T) Yeah that's really the product of you know the lead in segment that we had in our historical review. Was in the seventies and eighties you had a drastic expansion to cover low-income beneficiaries and their family members. So you can imagine pure capitalism at its best you have an influx of new insurances and a segment of the population is looking to benefit from it, namely the private sector who’s providing these services. So you can see how individuals providing these services would capitalize on this emerging market to expand their revenue.


(K) You can see that too in the eighties and nineties and even into the 2000’s, where pharmaceutical companies grew. I mean there was a time there and even still now where there is literally a pill for everything under the sun, there's a specialty for everything under the sun. So the pharmaceutical industry took advantage of that as well. You can see how spending has gone through the roof not necessarily because we’re needing more health care but a lot of it is because  the pharmaceutical companies expanded tremendously in the eighties and nineties.


(T) I think that's the philosophical underpinning to this entire argument is, there's really been a change in the way consumers approach healthcare. So you view at one time in our history insurance was a mechanism to were a catastrophic event would be covered. So you paid into a system on the auspice that on a particular shitty rainy day and you have a catastrophic event that would be covered. And over the course of time with this series of expansion over multiple decades, you really have a different consumer mindset where previously very individual centric, personal responsibility and likelihood that your dependency on your insurance was for that type of catastrophic event. Nowadays it's more of what can I pay into at the very minimum to pull back the most amount of benefits. And so you're talking about getting things covered from every day visits to cure a common cough all the way up to these catastrophic events. And so when you have that large expansion in coverage that's required so that way the average American doesn't have to pay out-of-pocket,  there's a significant cost incurred with that paradigm shift and that's kind of what we really seen today.


(K) For sure. Another factor that a lot of the left kind of brought up as to why our healthcare cost have gone through the roof is, they like to throw out the malpractice insurance and pay outs have caused significant increase in the cost of healthcare. What I did find is that it's very miniscule in the amount of money that is spent in healthcare, malpractice suits aren’t, it’s kind of like we’re trying to balance the budget and we're going to cut off something that we’re spending a billion dollars on. It has no bearing. So just to give you guys an idea of what this malpractice insurance and costs, the number of malpractice payments on behalf of doctors was the lowest on record in 2012 and it had been falling for 9 consecutive years prior to that. So that kind of gives you an idea that malpractice really isn't on the increase, because if malpractice payments have been on the down for the last 10 years or even more than that now, then Health Care should be coming down with it not going up. So that's one one factor. Malpractice payments as a share of our nation's health-care bill has fallen to a tenth of 1%. So the actual payments going out is literally less than 1% and then the medical liability insurance premiums for doctors has fallen to .36 of 1% so again less than 1%.


(T) I mean that’s really the power of messaging, right?


(K) Oh absolutely.


(T) If you can get a soundbyte and get people to latch on to it, that is critical for any strategic messaging campaign. You boil it down to its simplest terms,  you in a sense sensational something and you get people to buy in and you can get backing for virtually anything. It's a coalition of the willing that is quite frankly ill-informed and you know just latches onto the most simple narrative.  It can do wonders in moving something forward.


(K) So what I like to go from here, I just gave you. They said healthcare costs we're going up and these were the reasons that healthcare cost were going up. I kind of painted a picture that says well it's not necessarily why healthcare costs have gone up, they’ve gone up, but it's not because of the reasons they said. So what I did is i said well why are health care costs going up in this country because they’re going up, they’re just not skyrocketing, but they’re going up. So why are they going up? Here’s something that i thought was very interesting and very sad at same time. So Tony did you know that America is one of the heaviest populations on the planet?


(T) Yeah I've been to Disney World a few times, I’ve been to walmart a few times.


(K) Here's a disturbing number, the obesity rate the Americans 35%. If you include overweight to that 71% of America is either overweight or obese. So what does that mean? Being obese or overweight increases the risk factors for the two leading causes of death, which are stroke and heart disease.  Hmm interesting right?  Then let's take it a step further 18 and this is on the down but over 18% of Americans smoke. Leading to the two other causes of death, cancer and COPD. Smoking leads the lung cancer which is the most common form of cancer. So instead of saying that malpractice, medicine and things like that are causing the increase in healthcare costs, why don't we look internally and go maybe the problem is that the are an unhealthy population and it's our health, it's our eating habits, are drinking habits, it's are smoking habits that's creating the increase or the uptick in health care. Because we're needing more high blood pressure medicine, we’ve got people who are diabetic. I mean when did child obesity and child diabetes become a thing you know.  


(T) That's that's probably a whole nother episode, farm to table.  


(K) But you know that was something that I was like why are we increasing our healthcare costs? And that a pretty pointed observation, 71% of our population is overweight. I think a lot of you know, this is kind of getting off topic, but I think a lot of our problems with our healthcare system is that we are putting a bandaid on the problems that are in this country right. I was talking to Mark, the guy I fly with, and he made a very valid point. It's not Healthcare, it’s sickcare. We are taking care of sick people. Healthcare should be taking care of people for the long haul right? We should be making people healthier not just throwing drugs at them. We need to be teaching people how to be healthier. But we're get, I'll get on a really long tangent if I go that route. But that's something to think about, that our healthcare costs are being driven by an unhealthy population to say the least.


(T) So with that sick care, you gave out the 5 or so reasons as to why healthcare costs were ballooning and the reason why the Affordable Care Act was essentially implemented. I think the other reason why was that there was a large segment of the population that was not insured.


(K) Perfect, yeah.


(T) So you are wanting to essentially cover those who are left behind and insure that they have the proper Medicare to be that preventive maintenance and to get that Healthcare versus the sick care like you referred to before.


(K) And that's a perfect segue because that is very true and I will be the first person to say, I shouldn’t  say I'm the first person to say it but, there shouldn't be anybody left in this country that needs health care that can't get it. To me it should be, it's not a privilege to have healthcare, I think most of America can agree with that. You should be able, that should be one of your rights, you should be able to live long and prosper. So here's an interesting breakdown of people left uninsured. So prior to the passing of Obamacare Obama went on the warpath and said that there was approximately 46 million people that did not have insurance, that the uninsured rate hovered around 17% and we need to fix that. They tried to fix that, will get into this so we talked about the differences between Trump and ObamaCare, but they tried to fix that with the individual mandate 2014. Everybody has to buy it, so we went from 17% down to 10%. What I found interesting was if you broke down this magical 46 million people that didn't have insurance before 2010, if you took the demographics of these people and  broke it down it was interesting what you ended up with. So of the 46 million people 18 million of them made over $50,000 a year and you could assume that they would be able to afford insurance, that's kind of general but we can assume that they could do that.  What was interesting there was in the 18 million that made over 50K 8 million of that 18 made between 50 and 75 the other 10 over 75 K a year. Interesting that 18 million people had the ability to buy insurance and chose not to.


(K) Right and again that's kind of the fundamental flaw here is that you know when you're young you have that invincibility complex where you don't think anything's going to happen. You elect spend your discretionary spending on other things. So you want to take a trip to the Bahamas that's more important to me right now then paying a couple hundred dollars a month to get insurance. I think that was the real crux of the issue with the individual mandate and why there was that little back and forth with the Supreme Court on whether it was constitutional or not. By virtue of being born does that require you to pay taxes and essentially the individual mandate said yes. You will be required to enter into the healthcare system from the day you were born and I think a different nuance to that is that you know these people who theoretically had the means because of their income being above $50000 and all the way up to $75000 like you said before they have the means to do it but elected not to. And so at some point  those individuals are going to be barred from entry into the system under these pre-existing conditions but that was by virtue of a personal choice you know we're making a broad generalization here but theoretically it's by virtue of personal choice. You are electing to spend your income on other discretionary spending rather than opting into a healthcare system and then when you hit 37, 38, 39, 40, 50 years old and you have a condition and you go searching for medical insurance coverage, that provider is not going to take you on because you're high risk and your expensive. Had you been on the system well beforehand you would not be subject to these pre-existing condition causes that you know  


(K) Were barring a lot of people, sure. So in continuing with that this is the number that I found staggering 14 million of that 46 million people that were left uninsured, 14 million of them were low-income Americans and qualified for government assists programs such as Medicaid, the child health. CHIP I can't think of what it stands for, but they qualified for Medicaid and Chip but they didn't apply. And applying for it could be done at the hospital that you were at getting care, so 14 million just didn't apply.  So I found that pretty interesting. Another 6 million of that 46 million were eligible for employer-based insurance and chose not to take advantage of it. Another ten million were not US citizens, how are you even counting them in people who were uninsured. So you take all those really what you ended up with was anywhere between 8 and 18 million Americans who honestly could not afford insurance. What these were these were people who made less than $50,000 a year but made too much to qualify for government assistance. These were the people that realistically Obamacare was created to help. Not 46 million people that Obama was running around saying that he was trying to help, it was really 8 to 18 million. And you can see that if you look at the numbers who have signed up on the market places, it’s around 17 million I think is the number that I saw last. So that's the true meat on the bone , is that Obamacare was instituted to help anywhere between 8 and 18 million people not 46 million that they threw out there.  So that was Kevin going into his finance background and digging up numbers that nobody probably would ever look up.


(T) I honestly, the way I feel about that whole diatribe right now was. remember Old School when he


(K) That's how you debate


(T) He just passes out and he's like wait what did I say?  That's honestly the way I interpreted what just happened. With that being said  we are ready to move to our next agenda topic Kev if that's correct.  


(K) Yeah let's rock and roll man. So we're talking about the comparison between what Obamacare was and what Trumpcare was


(T) Yeah. ACA and AHCA. The Affordable Care Act vs The American Health Care in simplest terms we’ll refer to them from here on out as Obamacare or Trumpcare I think. So in my binning technique I think there’s probably 4 differences in the way Trumpcare and Obamacare approach healthcare. So you have subsidies, Medicare, insurance regulations and taxes. For subsidies really a fundamental difference in attacking that low-income demographic that we spoke about earlier. On the Obamacare side you have subsidies which was engendered to help the poorest people the most. You have a  certain amount of their income you would be expected to pay and that would essentially cover your portion as an individual responsibility and then the federal government with make up the rest. And so you could essentially get a mid-level plan by contributing 3% of your income and if that individual made about $20,000 per year which is right right at the of the poverty line. On the Trumpcare side completely different view, you have these flat tax credits. So anyone who earns less than $75,000 a year doesn't matter if you had 20,21, $22000 you're still getting the same tax credit and the range of credits for young people is $2,000 and for over 65 is about $4,000. So the design that was thrown around prior to its failure was that the tax credits to older citizens would be larger but the drawback is that the premiums anticipated we're going to rise more significantly for this demographic. And so you had the premiums going up because elderly people are about 5 times more expensive to care for than younger people and so that was really the rub here in that as premiums soared it would still leave,


(K) A significant amount, a significant portion of that demographic


(T) Footing the bill. Because that $4,000 wasn't necessarily going to cover your entire expenses. On the Medicaid side a little bit different here. Federal and State on the Obamacare side commits to pay a certain percentage of her medical bills regardless of the amount. On the Trump side the Federal government makes a determination on how much money is reasonable to send to the States and then the State must apportion and manage the outflow of support to each individual. The other aspect that's different here is that in 2020 the Medicaid expansion ends. So anyone who falls off the program can't get back in. So again that could leave many many many Americans without insurance.


Third bin is insurance regulations, so this was a bit strange for me and it really I think contributed to its overall demise in the house. You have Trumpcare which essentially kept the bans on pre-existing conditions, the ban on lifetime and annual limits, the ability to stay on the parent's plan until age 26, the essential health benefits which has been of top discussion in all the news. Those are the benefits that cover things like the maternity care, prescription drugs,mental health services, etc. It kept all those things intact. What it did do differently was it remove that controversial individual mandate but it quite frankly it replaced it with something that was virtually the same, it was named the continuous coverage. So this continuous coverage it's a surcharge on people who don't maintain continuous coverage. The individual mandate did it by paying that annual fine to the government you pay that in advance. The continuous coverage does it by recouping a 30% surcharge when you reenter the market at some point. And so that's kind of where I was going before was like hey you can elect to spend your discretionary spending on something else. If you remain out of the market for 1 year, 2 years 3 years, 4 years whatever when you decide to reenter the program you're still just going to get that 30% surcharge and you have to pay that for a year.


(K) Well and I mean another thing to look at to is even under the current system, even under Obamacare right now you know you're getting charged $675 for two and a half percent of your income whichever is higher. And it ended up being there's quite a few people out there who elected to take the penalty because it was cheaper than buying one of the plans on the marketplace. So i think that you kind of have it both ways where you’re getting it one way or the other. I think the difference here, and I think you kind of pointed onto it, but I think the difference here is that in Obamacare you're paying the government and in Trumpcare you're paying the insurance company.


(T) Yep, and then the final piece really doesn't go too far into the weeds here but the Trumpcare  basically keeps the Obamacare taxes in place till 2018 but there is a 600 billion dollar cut over 10 years with the program and that was mostly on the wealthy. So the messaging in the 24-hour news cycle is that look he's doing this exactly to benefit like-minded people like profiled people. He's targeting his wealthy rich friends to cut taxes for and it has kind of been label that regressive tax with negatively impacts the low-income contingent of our population.


(K) What I found funny was it was a talking head thing you know but it was Obamacare and Trumpcare are very similar packages, there just wrapped in different paper. There's some small differences but in general they are about the same. The differences are the winners is the way this paper read and the winners of Obamacare were low income families basicly. Where as the winners of Trumpcare are the higher-income families and the insurance companies. I think that's a pretty accurate assessment of it. If you’re going to brush broadly over everything. You know that's kinda where I think we sit with both plans, right?


(T) Yes it's just counterintuitive right because he ran his campaign off of two things


(K) Repeal and Replace, right?


(T) Right, repeal and replace and then he garnered a lot of the Blue Collar hard-working American vote on the fact that he was going to help them out and of course you know a lot of the elderly vote came out in droves to support him as well. And so you're seeing the very people that he whipped the vote persea, kind of turning that on its on its head and saying hey look you know had this pass and didn’t fail in the house, it would have definitely been regressive on the people that put him in office.


(K) You know I find this funny to, where's the middle class on this whole situation? The government has continually beat down the middle class. The middle class continues to shrink there's no doubt there. But where is the middle class in this whole situation they don't get the help, they're getting stuck with increasing premiums. I don't know if we're going to get into that but you know we're looking at up to a 25% increase in your premiums across the board because Humana and Aetna, the two largest health insurance providers, have left the marketplace’ They're not offering Obamacare plans any more. There's another situation where the middle class is to have a bigger effect. Because the people that are receiving subsidies they might see a little bit of an uptick but the government's going to cover most of that increase. And the wealthiest Americans they don't care, they have the means to cover it. So now you're talking about a guy like me or you that is now looking at possibly a 20% increase in my premium now I can't figure out where that money is coming from. You know it pisses me off and this is why I opened the podcast with you need to go out and research things on your own because as I got into this it's like here it is again the middle class is just getting the shaft once again.


(T) I don't know about you but I'm extremely wealthy……... spiritually, spiritually.


(K) That's what we’ve got time to do a podcast son.


(T) Sure, If you only knew


Anyways, alright man. So we’ve kind of beat around the bushes here but I think the next agenda topic is this Congressional opposition and why ultimate the Trumpcare piece of legislation just failed miserably in the house. I think that was, I want to say it was a shock to most people I mean I guess early on you could kind of read the tea leaves that said this thing was doomed. But when you have 7 years of lead up and an individual who campaigned and theoretical won on this one key piece of repeal and replace Obamacare to fall so hard and so fast within 17 legislative day working this thing, I was shocked.


(K) Well hey here is something to take in consideration, I was listening to a podcast and they brought up a topic that was brought up by The Young Turks. I don't know if you know who they Young Turks are and if anybody listening doesn't know the Young Turks they’re a group of guys that have a podcast they’re pretty liberal and what they came up with was rather interesting. They were saying that Trump doesn't want Trumpcare to pass because really it's Ryancare it's not Trumpcare, Trump really had very little to do with it it's just called Trumpcare because it's under his presidency. But they were saying that Trump didn't want this, he didn't really care for it and he was going to let Ryan take this to the house and let Ryan fallon the grenade so that Trump can come out later and say hey look it wasn't my plan that was the Republicans plan they didn't do a good job of making that happen. And use it as a way to bring his administration more towards the center and get Democrats to work with him. And this was coming from a liberal podcasts and I found that interesting because if you look at it this was not a repeal and replace,  this was a Obamacare light is really what it was you know. And when you’re the majority party and you can't get enough votes to bring this to fruition there something wrong with your plan boss


(T) Absolutely. That kind of leads into describing the Congressional opposition and why they couldn't get the 215 that they needed. You have this, well clearly no Democrat was going to vote for it right so that entire segment of the house is just null and void. But then you had the house Freedom Caucus. No one can confirm the amount of people who belong to this but essentially it's an Ultra conservative faction the Republican Party. Numbers have rumored between 30 and 36 individuals. They're fairly outspoken in the media, formed around 2010 time frame with the intent to push the House GOP leadership more to the right on certain fiscal and social issues. So this is one of their targets of opportunity. You know you really have this faction that's upset with the way things are going because again the Obamacare system was just so far over reaching, covered too many things and covered quite frankly too many people in their eyes. And so you have this segment of the Republican party which wanted to bring things more to the right. Kev you have anything else?


(K) No I mean that's honestly that's pretty much it right? It was the Freedom Caucus that basically shot the bill down. They were the ones that they didn't get the vote from that they needed to get to the 215 number. Like I said I think the whole thing to begin with was Obamacare light. I mean you can see it when we did the comparison, very little changed very little changed. We got rid of subsidies in place for tax credits, we got rid of the individual mandate but we created a quote-unquote mandate anyways. So the stuff they got rid of they just replaced with stuff that the quote-unquote RIght likes. We got rid of a subsidy and made it a tax credit, right so we were cutting taxes.  So good job we’re a Republican cutting taxes good job. They were just kind of checking boxes and I don't know it was a very poor plan.  It almost seemed to me like, here we are once again talking about a rushed legislation, because repeal and replace was a big thing but what was the deal we were going to get it done within the first 100 days of my presidency and that's what you ended up with. I don't think they got it in the 100 days I think it was a little bit after that. But like you said 17 days from when it all started talking we're going to get the votes for it to it fell flat on his face on the house floor you know that's what you get.


(T) Really what happened was Trump and Ryan had determine which faction they were going to appease and on the far right side when you give up the essential health benefits that made them happy but it came at a cost and detriment of votes on the moderate side. And so the Republican party essentially needed an effective strength of 215 or higher to get this majority that they needed to pass bills and conduct other business. And what we’ve seen was that they didn't come to a full vote but they obviously knew they couldn't whip it and get no less than 21 defections in the house and so with that being said they kind of just said hey look will move on and and Trump is already said let's move on to things.


(K) Yeah He wants to move on to tax reform I think is what he said next. Yeah I mean like I said I think it was just kind of doomed from the beginning. It was a poorly written plan and it was literally Obamacare light and it wasn't a repeal and replace that he'd promised the American population the people that put him in office was on repeal-and-replace and he was doing neither I think.


(T) Yes it was basically to expensive for old people to restrictive for poor people and then you mentioned it before the Congressional budget assessment where you have people over 50 their premiums with sore from $1,200 to $14,000 years what I saw and 24 million people could lose their coverage by the end of the decade so you had all these this this recipe for disaster.


(K) Well you know the other thing that I saw too was that it did nothing to curb the hit on the budget. It actually was going to have a harder hit on the budget then Obamacare is planned to have. So again it was nothing that they said they were going to do.


(T) On the way ahead here man this is really kind of just a sketchy way ahead for this episode.


(K) Yeah the way ahead, it's really hard to say what the way ahead is because while Obamacare had some very good points and while Obamacare has done a lot of really good things it's extremely expensive and it's only going to continue to get expensive. I mean the one thing that I did see that I didn't get into one was the death spiral. With premiums increasing, which they're going to increase again like I said earlier 20 to 25%, and that's a factor of many things and just kind of a brief overview of that. Insurance works as a pool of large numbers so you have to have a lot of people in the system. And realistically you want to have a balance between very sick people and very healthy people because it keeps the cost right because the healthy people share the cost for the sick people. So what you end up with now is the number of healthy people hasn’t gotten into the because it's either too expensive or like we were saying earlier they were younger so they’re the invincibles so they're not going to buy any. So we’ve got more sick people in this pool now and very little a healthy people so our premiums are increasing right. Well as premiums continue to increase healthier people are going to drop out because it's too expensive to continue paying for health insurance if they're not using it. So then what you end up with is basically this top heavy situation where you’ve got a lot of sick people, nobody's coming into the system to pay for it and eventually it just falls apart.


(T) In my opinion one of the worst things they could have done was to continue on the stay on your parent's plan until you’re 26. Because that is exactly the demographic you need to target to jump into the system to expand the coverage and expand the pool. I understand why very many Americans wanted that and especially with younger kids coming out of college these days having trouble finding jobs, especially the pay that they, in a sense,  think they're entitled to obtain. But these are very young healthy individuals who could offset the cost for those older people who need you know 5 times more with cost expenses. But ultimately where this leaves us in our way ahead is that Obamacare is still in place. So we've seen the CBO say that this is not into the death spiral, that's another soundbite and narrative that the right is trying to get people to latch on to. Ultimately we’ll see what happens but what we know today is this administration's rearview is tinted, they are not looking back. Trump has said hey let's move on to things like tax reform right. So he's not viewing this as crushing defeat. I think there's precedence in the past were other administrations have had this type of legislative fail early on particularly with health care. But the likes of Clinton you know had a very similar death spiral in 94 when he started to introduce his Healthcare reform in 93. But that was the difference, you have a  calendar year of work being done in and ultimately this one culminated 17 days like we discussed. So there is precedence but maybe not on this rapid time scale like we've seen here. This may be the catalyst to bring both sides working together to improve Obamacare,  we noticed some of the issues with it right and so this could be the mechanism by which both aisles come together and hey look let's fix the problems we have. We can't repeal and replace so let's make it work. I think the overriding fear is that the Republicans in their infinite wisdom are just going to sit back or maybe even sabotage it and find a way to advance this death spiral that's being touted in the news. And that way if it crumbles under its own weight they can say look we tried and you guys didn't want to listen. Not that that's going to be the best-case scenario because the people who didn't want to listen were quite frankly


(K) Their own party


(T) Dissension in the Republican party


(K) No and I think me and you kind of talked about this before we hit the record button but in my opinion I don't think there's a way you can have both systems. You either have a single-payer system or you have a multipayer system. You can’t have the combination of two I don't think. Maybe there is a way to get there but I think you either have to say we're going to be a single-payer system, we’re going to be socialized medicine, the government is going to take care of it all or we go back to privatize insurance. And I think that's kind of where we sit and I think that's the way ahead. Because while we sit here like you were saying Obamacare is the law of the land and that's the way it's going to be for at least the foreseeable future. I just don't know that because you have, you brought it up there's two diametrically opposed views in the house and actually there's, you can even say there's three at this point right. Because you have to moderates that kind of want the best of both worlds. You have the Bernie Sanders of the Democrats that want the single-payer system and then you have the Freedom Caucus basically that wants what we had before. So getting everybody to jump into the same ballpark to play the same game I don't see it happening and then on top of that getting everybody in America to say yes we're on board with that I don't see it happening I really don’t.  


(T) And on that note man you're a doom and gloom kind of guy. I think you do the best job of signing us off so you wanna go ahead and do that?  


(K) I just want to say thank you to everybody that's listened. I posted on our Facebook that we're now available on iTunes so you can you can search News World Order on iTunes and you can find us there. So people with iPhones or iPads can listen to us easily. If you subscribe on those anytime we dropped a new episode it will give you an alert. So that kind of cool so we’re moving up in the world there. For all the Android users out there I'm working on getting us on the Android side of the house so give me some time and I'll get us there eventually.


(T) I'm so sad that I actually crossed over to the darkside finally. I've been an Android user for so long and then I see like, I see Samsung teasing out their Galaxy 8 and I'm like oh my man why did I already move over.


(K) Because its the Galaxy 8 bomb


(T) Yeah I don't know we’ll see what happens. I guess it doesn't mean a whole hell of a lot for

me because I'm now locked into


(K) At least two years with the iPhone


(T) Yeah the 7 plus for however long until it shatters.  


(K) To funny. So Android users bare with me and we will be there eventually.  iPhone users you can get us on iTunes now. Again like always like us on Facebook, share this episode with your friends and keep coming back cuz we're going to keep pushing forward and diving through all of the minutia that is the talking heads out there of our 24 hour news cycle . So thank you for joining us tonight, we hope you enjoyed it, we hope you learned, hope I didn’t bore you too bad with my debating skills and we will see you guys next time.


(T) Take care guys

(K) Alright bye now.